Applewood Support 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 inspection we rated this key question good. At this inspection the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. Staff worked well in teams and met people’s care task needs. People were supported to live healthier lives. Staff understood the importance of gaining consent for personal 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.
The provider undertook assessments of care needs with people and their relatives prior to care calls commencing. Overall, this information was used to create individual ‘care tasks’ and a plan of care for people. However, we found examples of where some improvement was needed in assessing needs and ensuring important was captured in detail and used to ensure people’s health, care, wellbeing and communication needs were fully explored with them. There was no formal process in place to ensure reviews of people’s care records took place when needed.
 

The provider planned people’s care and treatment with them, including what was important and mattered to them, however, this was not consistently used to deliver evidence-based care. For example, where information had been shared during people’s assessment of needs, this had not always been used to develop ‘care tasks’ or prompt the use of clinical tools to assess potential risks of harm.
One relative told us staff did not always open lids of food items for their loved one despite staff knowing they had some paralysis and would either struggle or be unable to open the lid themselves. We found this person’s assessment of need recorded paralysis, but there was no further information of how this impacted them and how staff should support them with specific tasks. Another person’s assessed communication need included they had limited English. We found inconsistency in their plan of care as it referred to them verbally communicating their needs to staff. A third person had shared the importance of them remaining infection free, but this information had not been used in developing a related ‘care task’.
Where people were at risk of skin damage, evidence-based approaches, such as using clinical tools to provide a structured approach to assessment had not been used. Evidence-based care involves the use of clinical tools, such as WATERLOW assessments, to help improve people’s outcomes.
 

The provider worked well across teams and services to support people. The provider told us they aimed to place care staff who complimented each other’s skills and worked well together on ‘double-up’ care calls. There was a commitment by the provider on ensuring consistency of staff for people as far as this was possible. Staff shared positive comments about working together, these included, “It’s a good team here" and, “I think we all work well together.” Staff also told us, “We are supported by the managers.” The provider made referrals to people’s GPs on their behalf when needed, and also to the district nursing service.

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 remain as healthy as possible. Relatives agreed they were informed about what was going on with people, any changes in their health or wellbeing. People were referred to various health professionals to address any health issues or changing needs, this included district nursing teams and GPs. The provider shared an example with us of using electronic innovation to remind 1 person to stay hydrated. The person did not have a lunchtime care call, so the provider had used an electronic device which verbally prompted them to get a drink.

The provider generally monitored people’s care and treatment to continuously improve it and ensured that outcomes were positive.

People and relatives told us their feedback was sought by the provider and where feedback reflected improvement was needed, the provider acted on this. Some people shared examples of concerns they had raised with staff and assured us things had improved. One relative told us. “It was a really rocky start to the care at the beginning, we then had a meeting, and things have improved a lot.”
 

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

Staff understood the importance of gaining consent prior to supporting people with personal care and people confirmed this to us. One staff member told us, “I greet a person and suggest they have either a shower or a body wash on their bed, I ask them how they feel and what they would like support with.”