Farecare Gloucestershire Limited

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 Inadequate. 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 because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

The provider needed further time to embed new practices in relation to completing care records. While some improvements had been made, there were areas where additional work was required. Risk assessments were not always completed, and there was evidence sentences had been cut and pasted into different parts of the care records. While we could find no impact to people using the service, and care was delivered consistently, the manager required further time and support to ensure care records were holistic, detailed, and included people and their relative’s input.

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

We found one person needed support from 2 staff members; however, their care records only recorded them needing assistance of 1 staff member. Some areas of the care records which detailed how to support people with complex emotional needs was incorrect, for example, one care record stated the person may be at risk of self-harm, but when we spoke to staff, they felt this was not a realistic risk for the person. We could not find any corroborating information from external professionals confirming this was a risk for the person. The manager confirmed the person only exhibited signs of distress when being supported by new staff members. The care records did not reflect this.

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.

Staff told us they worked well together and supported each other to deliver consistent, joined-up care. One staff member told us, “Colleagues are so supportive.” Another staff member told us, “We all get on to be fair. There isn't anyone I wouldn’t want to work with.” Staff told us how they would escalate concerns if they found people were deteriorating and staff we spoke to were confident in how to follow the correct systems and processes.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Staff we spoke to were very clear about people’s needs, their goals and aspirations. Staff knew which people liked to go for walks, wanted company or may be interested in community events. Staff told us how some people had specific exercises the occupational therapist had given them and staff encouraged and supported people with these with the goal of having greater mobility. However, care records were not completed around these areas and provided conflicting information. For example, one person’s care record stated they used 2 different pieces of moving and handling equipment, but this was contradicted in another part of their care record which stated they used a hoist. Although we did not find this had an impact on the person, care records were not clear or consistent, which could lead to staff providing inappropriate care.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

While staff completed daily records and had tasks for each person they needed to tick once completed, we found a lack of monitoring by the manager. Staff would not provide adequate details in the notes about any concerns they had. Staff would call the office, but these conversations were not always recorded. While managers and senior staff appeared to have good knowledge of people’s needs, this was not consistently recorded and therefore could not be monitored. We found one person who had a pressure sore did not have a body map in place.

A body map is a visual diagram of the human body used to accurately document, track, and communicate the location of injuries, skin integrity issues and where to apply some types of medicines.

The provider acknowledged the evidence found and worked to make improvements to their oversight of completed tasks and skin integrity.

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

People told us staff asked for consent before beginning personal care, one person told us, “They are very polite and kind and check I have consented before doing anything.” Staff we spoke to were very clear on consent, one staff member told us, “I always ask people before I touch them, before I do anything. I make sure people feel safe and treat them with respect. I wouldn’t pick up their legs and move them without telling them what I am doing.”