Zara Healthcare

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.

This was our first assessment of Zara Healthcare Ltd, and we rated this key question good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, well-being and communication needs with them.

People had an assessment which they said was completed with their involvement and, or the involvement of their family. Care plans were reviewed and any change in needs were discussed with staff and relevant professionals. Daily notes were audited and showed staff were proactive in identifying and responding to people’s changing needs. A staff member told us,” When supporting a new client, care plans and risk assessments are implemented to ensure safe, effective, and person-centred care.” They also said should there be an accident the circumstances would be recorded and reviewed to ensure any risks were clearly identified, removed and reflected in the plan of care.

A person using the service told us, “The manager or the team leader come here, either when they’re doing a spot check of staff, to do the care themselves, or for a reassessment. They ask how things are and I can add things into the care visit, change the plan, if time allows.”

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.

Outcomes were clearly defined as part of the assessment determining what was important to the person and what they would like from the service. Social support was incorporated into the assessment and recognised people could feel lonely and vulnerable. For example, if they had experienced a bereavement. There were clear examples of how staff could support and comfort people and reminisce with them.

There was a good description in the care plan as to what was important to people to help staff deliver informed care. Staff monitored outcomes of care to ensure people’s needs were met and people received care essential to their needs such as medicines, adequate skin care, nutrition and hydration.

Staff were kept up to date with training and professional development was robust. Staff explained they completed induction, skills for care induction, both face to face and online training and told us about the practical application of their training.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

Feedback about teamwork was positive from people using the service, one person told us, “They’re regular staff, I know all their names and importantly they know what my needs are – they understand. They’ll call the Dr or the nurse for me, if necessary.” Another person said, “I’ve got regular staff, I’ve got to know all of them. They know me really well and what I can and can’t do, I don’t have to keep explaining it.”

The team had a good mix of experience with clearly clarified roles and a good working relationship with other professionals who told us joint working with this agency was seamless. Clear documentation and communication made it possible for this service to exceed people’s expectations.

One staff member working on an ad hoc basis to support the manager with assessments and care planning had both a nursing and social work background. They were able to describe how this supported them to develop holistic assessments and work in collaboration with other professionals having established good networks of support. Professionals told us this agency went, “above and beyond” and would succeed in taking on more difficult care packages due to their knowledge, experience and can-do attitude. They also said they would source training to equip their staff and had accessed training from the local authority, the local hospital and more bespoke training when required.

Whilst staff often worked remotely there were clear lines of support and staff said they felt connected to the wider members of the team. For example, one staff member said, "My manager and team leader provide valuable guidance, feedback, and reassurance, helping me maintain high standards of care and address any issues promptly.” Another said “Yes, there is very good teamwork within our team. We support each other throughout the day, starting with daily huddles where we share handovers and discuss any important updates. This helps everyone stay informed and ensures continuity of care.” The registered manager told us of events both formal and informal to support with staff integration when they were entering the country to staff social events and recognition schemes where staff had demonstrated excellent practice and were awarded with vouchers.

The service used a combination of daily handovers, app notifications, and direct communication with staff and people using the service to ensure all felt appropriately supported. We found the manager and team leader present at the inspection were powerful communicators and advocates demonstrating a good knowledge of people and staff and having an awareness of any issues within the team such as unhelpful banter between different staff members. Where issues were identified they were quickly addressed.

The provider always supported people to manage their health and well-being to fully 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 being supported had a number of health needs and risks associated with ageing which were clearly documented, and staff were aware of how to escalate concerns, communicate with families and how to safeguard people. People told us without exception staff noticed and acted on changes. For example, one person said, “They [staff] always pick up on things, they notice if something isn’t right and they’re concerned. Another said. “They always ask me how I am and they care about the answer. They definitely look after me and would notice if I didn’t feel well and would advise me or call someone for me.”

Staff understood the importance of respecting people’s autonomy but also addressing concerns about their changing health. For example, staff monitored risks associated with falls and ensuring people had the equipment they needed. They monitored risk associated with improper use of medicines and unintended consequences should a person self-administer to ensure they could continue to do so safely. They monitored skin integrity and raised safeguarding concerns particularly if they felt other agencies were not taking appropriately timed actions. They monitored people’s food and fluids. Staff also cared for and took an interest in people’s mental health and social support. For example, we asked a staff member what they would do if a person was refusing care. They said, “I would first remain calm and respectful and try to understand the reason for their refusal. For example, if they refused to have a wash, I would explain the importance of personal hygiene for their health and well-being and offer alternatives that make them more comfortable, such as letting them choose the time, using familiar routines, or incorporating something they enjoy making the process easier. I would also report the refusal to my team leader or senior staff to ensure that the situation is monitored appropriately. All actions and observations would be accurately documented in the individual’s care notes.”

Another staff member when asked about health told us that they communicated regularly with the GP, district nurses, also the pharmacists when required. Staff were trained in specific aspects of health care in line with people's needs including skin care and applying simple dressings. They were trained to use equipment safely and report defective equipment including mattresses, which might be detrimental to the person’s health. Staff told us about their training and how they could implement this in the workplace. A staff said: “The first aid training equipped me with the skills to respond appropriately to emergencies, including CPR, managing choking, minor injuries, and reporting incidents correctly.”

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Robust monitoring of people’s care needs helped to identify strengths in the service but also areas for staff development and improvement. Actions plans were created in response to audits, spot checks and feedback from staff, those who used the service and relatives. We saw clear examples of actions taken in relation to feedback from the local authority and CQC.

Lessons learnt were clearly embedded in the auditing process. When mistakes were made these were reviewed in a supportive way and considered staff’s training and support needs. Staff had regular opportunity to discuss their workload and how they were feeling, as well as looking at training and self-development needs.

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

We saw evidence that initial assessments were carried out before the commencement of service delivery. Throughout the inspection we saw clear examples of how people’s choices in care were promoted and how staff delivered care in line with people’s needs. If staff were not able to obtain valid consent, they knew what actions to take to escalate concerns if needed for the safety of the person concerned. For example, one person said, “They wouldn’t do anything without asking me, they’re very good like that.” Another said “They speak to [relative], they explain what they’re doing and always get her consent. Sometimes they speak quickly and have to repeat it.”

Staff told us they completed training that included The Mental Capacity Act 2005 and codes of practice. They all demonstrated a good understanding of person-centred care which underpinned people’s human rights and the Equality Act 2010. Staff told us how they promoted choice and independence by building up respectful, supportive relationships. Families were consulted in line with the persons wishes.