Evelyn Grace Ltd

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 outstanding. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.
 

This service scored 79 (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, wellbeing and communication needs with them.

People and their relatives confirmed they were involved in the assessment process. Care plans contained detailed guidance to support staff to provide personalised care, and assessments were reviewed when needs changed. The registered managers knew people’s needs well as they carried out the initial assessments and visited people to carry out the support and care they needed.

The assessment process gathered a wide range of relevant information, including emergency contacts, mental health needs, hearing and communication needs, mobility, key safe information and environmental risks in the home.
 

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. The registered managers used personalised documentation to guide practice. A ‘page in the day’ document was used to record evaluation of care, food and fluid, bowel movements, bruising or injuries, and medicines. A registered manager confirmed this was bespoke for each person and checked regularly to ensure staff were supporting people as per the guidance and information documented.

Care plans included practical, person-centred strategies, such as detailed instructions for supporting a person with a stoma bag, and step-by-step guidance for personal care routines. Staff spoke positively about the quality of the care plans and how updates were communicated. This helped ensure care delivery reflected current good practice and supported people to achieve meaningful progress in their lives.

The provider always worked well across teams and services to support people. They shared relevant and important information with external professionals which helped people’s experience when using other services.

All the people and relatives that we spoke with gave us very positive feedback about the staff team and how they worked all together. One relative told us, “[Person’s] care team is a close-knit group who share a common approach, they’re terrific.” Another relative spoke highly of the registered managers. They commented, (Registered manager), is just brilliant and always ready to help. One example, we seemed to be always running out of continence pads. They (registered manager) sat down and drafted an email for me to send which was very precise and direct. I couldn’t have done it on my own, but it did the job and got results very quickly.”

We saw numerous examples of where the registered managers regularly communicated with people, their relatives and professionals. This enabled people to feel listened to, relatives to be informed of any problems and professionals to carry out their assessments to help people continue to live in their homes. Everybody spoken with felt the team all worked very well in people’s best interests.

The staff team all pulled together when people needed it. One person had been low in their mood whilst in hospital. Staff sent in individual cards to the person, so they knew they were being thought of during a challenging time in their lives. The person’s relative told staff it had made a difference to the person who was pleased to see they had been thought of.

Communication was clear between the registered managers and staff team. This was via emails, direct conversations and using a group messaging app. Staff spoke highly about the support they received and the good teamwork. Comments included, “We are made aware (of any issues) via email, and a message will also be sent to our phones to make sure we read the email” and “I have also seen first-hand how responsive and aware they (registered managers) are of all their client’s needs. It’s very refreshing to see.”

Staff were confident they could escalate concerns and seek professional input, supporting continuity of care. The majority of the day-to-day care documentation was in a paper format, and staff kept the 2 registered managers up to date following each visit to a person. This enabled the management team to quickly respond to any issues or changes and update the records.

The provider always supported people to manage their health and wellbeing 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.

Relatives described care that helped people’s emotional wellbeing. One relative told us, “We buy food for him weekly, and the carers heat them up. But they go one step further and often sit with the person while they write their report, and chat. The person lives in a nearly permanent state of anxiety, and these little things do matter.”

Staff supported people to get medical help promptly when required. A relative told us, “A little while ago they arrived and found that [person] was quite poorly, really ill. They (care staff) called the emergency services and waited until I arrived.”

Staff were active in monitoring people’s physical and mental health. Care plans and emails included guidance for staff about healthier living, preferred food options, and supporting people with their mental wellbeing. Staff supported people to access health services, as and when this was required. Adjustments were made to the support people received following periods of ill health, when people required extra support to stay at home, or needed short notice support if they were coming out of hospital. The 2 registered managers made sure people were not left without care and support.

The registered managers used structured approaches to monitor and promote health. This included information for care staff on supporting people in colder and warmer weather. Audit summaries showed staff (including the registered managers) were observed supporting people with oral hygiene, the registered managers described how they checked whether care plans accurately reflected the equipment and support needed in the person’s home.
 

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

The registered managers and staff team considered people in a person-centred way. One example was where a person was isolated and had not left their home for a long time. With the support and encouragement of staff, a trip out was planned to a place in the community of the person’s choice. During this outing the person met with other people, had a drink out and purchased some items. Following this event, they reported a good night’s sleep and relayed the joy of that outing to their relatives and other staff.

The registered manager explained how staff monitored people’s progress or deterioration and acted quickly to help improve people’s lives. We were told of where staff worked with a person, their family member, Speech and Language Therapist (SALT), Community Dietitian, and District Nursing team to support the person who had complex needs stemming from their health conditions. This included, monitoring weekly their weight, carrying out daily skin checks and where necessary staff would then alert the district nurse team so that the care plan could then be amended. Working with the SALT team also enabled changes to be made to the food the person could safely eat.

Outcomes for people were monitored through daily records, audits and management oversight. Staff understood how to report changes in people’s needs, and managers acted on this information. One person confirmed, “My care plan gets tweaked when there’s a need but the way our relationship works is that it constantly shifts as and when things change.” Several staff described always checking people’s care plans to make sure they supported people appropriately. One staff member told us, “If it’s a new client, I will make sure I familiarise myself with their care plan before seeing them and also whilst I’m in the first call and of course ask any questions and get to know them better.” By staff checking people’s needs and what had been documented, enabled them to support people in achieving the best outcomes on each care visit.

People were supported by regular staff helping them, so they and their relatives felt secure in the knowledge that staff understood people’s needs and supported them to achieve positive outcomes in their daily lives. One person told us, “I’ve got lots of hobbies and interests, my carers take an interest in things I like doing. One likes to help me fill up the bird feeders in my garden.”

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

People’s care plans recorded where they needed help with daily decisions. People spoke of staff supporting them in such a way that did not control them. One person said, “I never feel they (care staff) want to take over.” The registered managers confirmed they would make it clearer if they had seen proof that relatives and people’s partners had lasting power of attorney related to finance and/or health and welfare.

We were informed one person had two restrictions to keep them safe. One of the registered managers confirmed the person had capacity but would review the care documents to make sure it was clearly documented that the person agreed to these restrictions.

Staff completed Mental Capacity Act training and feedback from staff confirmed they needed to promote people’s independence and rights.