Share the Care Limited Office

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• 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

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we did not review enough quality statements to rate this key question. The quality statements that we did review; kindness, compassion and dignity and independence, choice and control were both rated inadequate. At this assessment we reviewed all of the quality statements and the rating has changed to good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

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 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.

At our last inspection we found that people’s needs had not been assessed. Since our last inspection, the provider had re-assessed everyone’s needs and had implemented new care plans. Relatives told us, “[The provider went] through the care plan and check that there hadn’t been anything to be added or alterations,” and “They sat here with me yesterday for about an hour to update their system.” However, some care plans lacked detailed guidance, for example around diabetes and the risk of skin breakdown. Some plans did not clearly explain what staff should do if a person’s condition changed. The provider agreed to review these and make them more person-centred.

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

Although staff told us they supported people in line with best practice guidance and were confident in supporting people with complex health conditions including diabetes, we found that national guidance was not always used to support people’s care. For example, the provider had implemented a MUST tool for all people, however this was not fully completed, and therefore could not be used accurately. 'MUST' is a five-step screening tool to identify adults, who are malnourished, at risk of malnutrition.

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 worked collaboratively with families and health professionals to meet people’s needs. One relative commented, “If there is any problem with dad the carers or office call us. When the carers have called the office then followed up afterwards.” Another said, “They liaise with physios and give instructions for carers attending.” Staff described good communication with district nurses and the office team, ensuring continuity of care. Records showed carers escalated concerns promptly, for example when skin changes were noted. The service used an electronic care system to share updates and ensure staff had access to current care plans.

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 supported people to live as healthy lives as possible, whilst understanding their rights to make their own choices. Staff monitored people’s hydration and nutrition intake, and told us they always made sure people had plenty to drink before they left. Staff spoke with us about the importance of encouraging people to stand when they could, and mobilise as frequently as possible, to retain as much independence and muscle memory as possible.

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.

The provider ensured daily notes were read daily to ensure action was taken to support people’s care and treatment when needed. People and their relatives confirmed carers were proactive in contacting GPs when concerns arose. For example, one person said, “The carers kept an eye on my heat rash and [office staff] rung up because she’d seen it from the notes and asked if she wanted her to phone the doctor for me.”

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

At our last inspection we found that people’s consent to care and treatment was not being sought. At this inspection we found this had improved. Staff understood the importance of consent and capacity, and records showed assessments were completed where needed. People, relatives and staff told us that staff sought consent before providing any care to them. Where people had capacity but they made decisions that were not in their best interests, these were documented within care plans, with staff telling us they respected these decisions. One person told us, “They always ask me what I want to do and respect my choices.”