Excellence Healthcare

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective.

There was a process in place to ensure people had their needs assessed prior to receiving a service, however they were not always effective. Assessments were completed with people and their relatives and formed the basis of people’s care plans. However, people’s care plans did not always contain sufficient detail on some health conditions, moving and handing needs and not all risks to people were identified and planned for. The provider told us they would act on our feedback and ensure where needed, the additional information was added to people’s care records.

Relatives confirmed they were involved in planning and reviewing their relatives care, they told us care was adjusted to meet any changing needs. Everyone we spoke with told us they were happy with the care and support being provided by the service.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Information in people’s care plans gave some guidance to staff but were not always consistent and robust. For one person we saw recommendations made by health care professionals were clearly followed by staff and the recommendations were documented in the person’s care plans. However, we saw for another person that although potential risks in relation to eating and drinking were recorded in the initial assessment documentation, this information was not always clearly referenced in the associated care plan and risk assessments. We did not see that best practice guidance was available for staff to ensure people received the correct levels of care. For example, in relation to swallowing difficulties.

Relatives told us staff knew their family member well and provided good care and staff we spoke with were aware of people’s risks and how these were being managed.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider talked through the system in place to review information as needed and to ensure information was shared effectively for staff attending the call. We saw an example where the provider and staff worked closely with a district nurse regarding regular changes in relation to a person’s dietary needs. The provider visited the person’s home and relevant changes were made to the care plan and staff were kept updated.

The provider did not always support people to manage their health and wellbeing, so peoplecould not always maximise their independence, choice and control.

Staff said that they would contact 999 and inform the office if a person they were caring for was unwell. Staff told us they had immediate access to emergency contact information and worked closely with people’s relatives to monitor and prevent deterioration in health conditions.

However, through discussion with the provider and staff it became apparent that where a person had attended medical appointments with a family member that may impact their care, records were not always robustly updated to reflect the outcome of the appointment. The provider told us they would take action to ensure the information was sought from relatives and implemented into the person’s care records.

Relatives told us staff were proactive in reporting any concerns about people’s wellbeing or changes in their health.

The provider monitored people’s care and treatment to drive continuous improvement. While most areas were managed effectively, some improvements were required.

Relatives told us they were involved in the planning of their family member’s care. Care plans reflected some details of how the person would like to be supported. However, further development was required in including in relation to some health care needs and moving and handling needs. It was also not always clear how staff should support people to maintain their independence. People’s care plans were not being robustly audited to ensure all risks were assessed and mitigated.

Relative’s shared lots of examples of how their loved one’s received excellent support and care from caring and kind staff. A relative told us, “They [staff] are excellent and go over and above.” Another relative told us, “The staff are really good, and they [person] respond so well to them.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Mental capacity assessments were completed during people’s initial assessments. Staff told us they sought verbal consent before each task, explained what they would be doing and respected people’s choices and independence. Staff involved relatives where appropriate and observed non-verbal cues to promote comfort and emotional well-being.

Staff confirmed they had completed the relevant training. A staff member said, “I always ask people for their consent before providing care, If I had any concerns about how a person was responding to care, I would speak with their family and the manager.”