Archangel Home Care

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 requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed

This service scored 67 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed and included consideration of their physical, mental health, sensory, social and communication needs. A holistic initial assessment informed the care plan. Care plans were written in a person-centred way and contained details about the person’s life, dreams and wishes, however care plans were not always completed by people who had received training for doing this task, Staff told us care plans helped them provide the best support for the people they cared for. One staff member said, “When I have read service user’s support plans, it has given me the right amount of information needed to help me provide them with the level of care they need.”

People were involved in the assessment, care plan writing and reviews. Where appropriate, families and professionals were also involved. One person told us, “They came out to talk to me about the care I needed and wrote a care plan with me; it is here with me. Every day the carers write in it, and they have just updated it, they do that every year.”

The provider was not always aware of best practice guidance.

The provider did not always ensure guidance was followed for people with specific health conditions. Guidance says for some specific health conditions, where a decline in health occurs over time, early and ongoing opportunities to discuss advance care planning should be in place. This was not always completed.

Whilst the manager was not aware of the CQC statutory guidance for what good care looks like for people with a learning disability and autistic people, the care people received did meet the requirement.

The provider worked well across teams and services to support people. All relevant staff at the service could access the information they needed to understand people’s needs and appropriately deliver people’s care, treatment and support. Staff worked proactively with other services when required.

Staff supported people to attend health care appointments and when people were unable to attend, staff liaised to re-arrange these appointments and people confirmed this.

When people were admitted to hospital, staff ensured a successful return to their home. One professional told us, “The provider has worked collaboratively with me, in the best interests of the (person), recently supporting a hospital discharge to a high standard.”

When the provider identified a need outside what they were contracted to deliver, they adapted their support and told the relevant agencies. A professional who works with a person Archangel Home Care support told us, “When there have been concerns or gaps, (Archangel Home Care staff) have raised these promptly and escalated appropriately.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff had received training about ways to support people to have healthy diets where this was required for specific health conditions, this was also recorded in the person’s care plan. Care records showed staff had passed on this information when providing meal choices and supporting the person with food shopping. One person told us to support them to eat a healthy diet “the carers take me out shopping and help me to choose food.”

The provider identified a way to support a person to self-administer medicines more easily. This ensured the person was able to maintain more independence with their medicines.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People’s skills, life experience and strengths were discussed with them and those involved in their care, when completing and reviewing their care plans. People were asked about their goals, and opportunities were identified to support people to achieve these. One professional told us, “I feel as a provider they have been very good for (person) and work with (them) to achieve (their) outcomes.”

People were happy with the outcomes of their care. One person said, “They always talk to me and ask me if everything is okay”. People told us they were given opportunities to feedback about the support they received.

The provider was not always consistent in their approach to consent and identifying people’s capacity. However, staff had a good understanding and respected people’s rights when delivering personal care.

Care plans, care plan audits and risk assessments showed people’s capacity was not always recorded consistently. One person’s records were inconsistent. In one section, it stated they had capacity; in another, it said their capacity fluctuated. Elsewhere, it recorded that they could make day‑to‑day decisions, while also saying their family could support them to make decisions.

Staff had all received training to enable them to support people with decision making when people were unable to make decisions for themselves. Staff knew how to help people understand what the different choices might mean for them and allowed them sufficient time to consider the options. Staff gave good examples of how they gained consent from people, and they told us they checked a person’s understanding by repeating back what had been said. Where people required support with communication, care plans reflected the need for staff to give people time to make decisions and to check people’s understanding.