Archived: Surrey Helping Hands 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 good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support was not always consistent.

This service scored 54 (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 include information about people’s health history when assessing their needs. One member of staff told us, “We need to have the medical history in the care plan. If we call the paramedics, the first thing they ask for is their medical history and we don’t know it.”

However, people and their relatives explained they had met with the registered manager and discussed what they wanted from the service, and this was included in their care plans.

The provider did not always plan and deliver people’s care and treatment with them in line with legislation and current evidence-based good practice and standards.

Some people’s assessments and care plans did not reflect best practice guidance issued by The National Institute of Health and Social Care Excellence (NICE) in areas such as nutrition. Where the care plan stated people needed to be weighed weekly, there was no information as to why this was required.

The provider did not always follow good practice guidelines issued by NICE or CQC for the safe management of medicines. For example, medication care plans and medication administration records did not always reflect the required medicines support.

The provider did not have any adequate auditing processes in place to assess and monitor the delivery of care to ensure it adhered to recognised standards and relevant legislation.

The provider understood their responsibility to work collaboratively with external stakeholders to ensure they had the information deliver to people’s care, treatment and support effectively. However, records showed people’s needs and risks had not always been adequately assessed to enable full and accurate information to be shared with other teams or other professionals should an emergency occur.

Where people were supported by familiar staff who knew them well, we found this promoted opportunities for good verbal communication with the person’s GP and local district nurse teams who supported their health. Staff had a WhatsApp group and any information staff needed around any changes was communicated this way. One member of staff said, “We have also a group chat, so they notify us about anything. We have communication every day.”

Staff monitored people’s health and contacted healthcare professionals when needed. People told us staff supported them to stay safe, healthy and well. One relative told us, “The carers were the ones who flagged it (a health decline) and even arranged taking my dad to the hospital. They facilitated it all.” Staff told us they would share concerns about people’s health with external professionals. Comments included, “We get hold of the speech therapist, and they come out and assess if the clients need thickener” and, “If I have any problems, my first point of call would be to report it to our office. and they would get the right people to support. If anybody is really unwell, I phone 999.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure records demonstrated positive outcomes and consistency in care, or that they met the expectations of people themselves. For example, where people had risks relating to increased anxiety, we found the provider was not routinely reviewing this. We found no evidence of harm; however, the lack of effective monitoring increased the risk of this person having a poor mental health outcome.

The provider had a policy to guide staff on how to assess people’s capacity to make decisions in accordance with the Mental Capacity Act 2005. However, this guidance was not always followed. Where there were concerns about a person’s capacity to consent, we did not always find evidence of a decision-specific assessment of their capacity had been undertaken. This aspect of service delivery required improvement.

Staff understood the importance of gaining consent prior to supporting people with care. A staff member told us, “I would ask if I have got consent to do something and to make sure they are comfortable with what I’m doing. I would always explain what I’m doing as I’m going along.”