Bosun Care 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 of the provider’s previous registered location, we rated this key question good. At this assessment the rating has remained good for the assessment of the provider’s homecare service. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

People’s support and care requirements were assessed before the start of a ‘live-in care package’ to ensure the service could meet their needs. The homecare manager had visited people and their relatives in their own home to gather as much information as possible including their medical background, care requirements, risks, medicines as well as their preferred routines, meal preferences and dietary needs. This information informed people’s care plans. The deputy manager was in the process of updating and reviewing people’s care records on the provider’s digital care management system. This would enable the registered manager to have better oversight of the care being provided and changes in people’s needs.

Not all people were clear about the terms and conditions and the working arrangements of being supported by a ‘live-in’ staff member. Staff said they remained as flexible as possible. The provider had recognised the provider’s ‘welcome pack’ needed to be updated to reflect the provider’s policies and practices of the homecare care service.

Emergency documents had been created to share with professionals and health services in the event of an emergency. However, not all documents contained key information which may assist professionals in supporting people in an emergency. The registered manager said people’s emergency documents would be re-assessed as part of their review of people’s care plans.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People confirmed they received an initial assessment visit by the homecare manager and were asked about their care and support needs.

The provider had implemented an action plan to review all aspects of the live-in homecare service to ensure current guidance and care standards were used when assessing people’s needs to ensure people's physical, mental and social needs were fully assessed, documented and understood by all staff and managers associated with the homecare service.

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.

Processes were in place to ensure staff received timely information about people before they started to support them. An effective system of handovers occurred between staff changes. One staff member said, “We get to spend one day with current carers before they leave. It’s a good and nice long handover and we talk about everything; from people’s medicines, food and activities they like.”

Staff worked collaboratively with people’s relatives and professionals to support and monitor people’s well-being and make timely referrals to health and social care professionals to support positive outcomes. Staff said they had been in regular contact with the homecare manager who provided advice and support as needed. The registered manager identified improved recording of the outcome of professional referrals was needed to ensure people received appropriate care and support.

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.

People were supported to maintain a lifestyle and eat healthy meals of their choice. Where required, people had been supported o access routine and specialise health appointments and health checks.

Staff said they knew people well which enabled them to observe any changes in people’s health. Any concerns were raised with the homecare manager.

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.

People’s care records prompted staff to monitor and record the care they provided; however records of staff’s care delivery were not always consistently detailed and did not always reference the control measures needed to manage people’s risks or the monitoring of their needs.

However, the provider had identified further development and oversight of staff recording keeping and monitoring of people’s risk was required as a priority.

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

During people’s initial assessment, an assessment of their cognitive ability to make specific decisions about their package of care was documented to ensure people’s care was delivered in their best interest. Information about people’s lasting power of attorneys was requested during the initial assessment but not always obtained or recorded.

People stated staff always gained their consent when care and support was being provided to them. Staff understood the principles of the Mental Capacity Act 2005 (MCA). They told us that everyone was deemed to have capacity to make decisions unless it is established that a person lacks capacity. They were aware of the concept of decision specific assessments. They provided examples of people they supported who lacked mental capacity.