Total Health Support and Training Services 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 we rated this key question requires improvement. 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 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, wellbeing and communication needs with them.

People had care and support plans which provided guidance for staff on how to meet their needs. Records showed these were reviewed regularly and updated when people's needs changed. Assessments considered a range of needs and preferences and supported the provider to determine whether they could meet people's requirements safely and effectively.

Assessments were completed by experienced senior staff and involved people and, where appropriate, their relatives or representatives in discussions about their care and support needs. This helped to ensure care planning reflected people's wishes, preferences and current circumstances.

People told us they were involved in reviewing their care and support. One person said, “the care plan is reviewed formally, and informally when they call me." Another person told us the provider carried out annual reviews and regular visits to check their care continued to meet their needs.

The provider planned and delivered people's care and treatment with them, including what was important and mattered to them. Care was delivered in line with relevant legislation, guidance and recognised good practice.

People's needs were assessed holistically, and information gathered through these assessments was used to develop personalised care plans and risk assessments. Records showed assessments considered a range of areas, including mobility, skin integrity, nutrition and hydration, where relevant to people's needs.

Care plans provided guidance for staff on how to support people safely and consistently. Records showed these were reviewed and updated when people's needs changed to help ensure care remained appropriate and responsive.

This approach supported staff to deliver care aligned with people's assessed needs, preferences and identified risks. Staff received training relevant to people's needs, including specialist areas of care, which supported them to deliver care in line with current good practice.

The provider worked effectively with other teams and services to support people. Information about people's needs was shared appropriately with relevant professionals to help ensure continuity of care and reduce the need for people to repeat information about their circumstances.

Staff worked alongside healthcare professionals and other agencies involved in people's care. Changes in people's needs or circumstances were communicated effectively within the staff team and discussed during handovers to help ensure care remained consistent, coordinated and responsive.

Feedback from healthcare professionals was positive and confirmed the service communicated in a timely manner and provided clear and accurate information when required. One professional told us the service kept them informed of any changes and worked proactively to ensure care packages continued to meet people's needs. The care manager maintained oversight of people's care and engagement with external professionals to support positive outcomes.

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 demonstrated an understanding of how to recognise changes in people's health and wellbeing and knew when concerns should be escalated. Care plans contained information about people's health conditions, how these affected them, and the support they required. This provided staff with guidance on how to meet people's needs consistently and respond appropriately to changes in their health.

People were encouraged and supported to maintain adequate nutrition and hydration where this formed part of their care package.

Staff followed guidance from healthcare professionals and supported people to maintain their health and wellbeing. They understood the importance of recognising and reporting changes in people's needs so appropriate support could be sought when necessary.

The provider routinely monitored people's care and treatment to help ensure positive outcomes and support remained responsive to their needs and preferences. Systems were in place to review the quality of care provided and identify opportunities for improvement.

Staff and managers carried out regular reviews of care plans to help ensure they remained accurate, up to date and reflective of people's current needs and wishes. Staff told us they monitored people's health and wellbeing through regular contact, observation and the prompt reporting of concerns, enabling appropriate action to be taken when required.

The care manager maintained oversight of the quality of care provided through care reviews, spot checks and ongoing monitoring. This helped identify changes in people's needs and ensured care and support could be adapted where necessary.

One relative explained staff understood their family member's health needs, including wounds were managed by the district nurse. They told us staff monitored the wounds during visits and, "if they notice anything of concern, they'll raise it with me."

Another person described how staff monitored their wellbeing and encouraged measures to help keep them safe. They told us staff, "have persuaded me to have a pendant alarm so I can press it if I have a fall."

The provider informed people of their rights relating to consent and respected these when delivering person-centred care and support. Care records reflected people's preferences and choices and provided guidance for staff on how people wished to receive support.

The care manager worked with people, staff and relevant professionals to promote people's rights and support person-centred care. Care plans included information about people's ability to make decisions and any support they required to do so.

People were supported to have control over day-to-day decisions. Staff described how they gave people time to make choices and respected their preferences. People and, where appropriate, their families were involved in decisions about their care and support.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack capacity to make specific decisions for themselves. Staff had received training in the MCA and the provider's policies reflected the principles of the Act. Mental capacity assessments and best-interest decisions were completed where required.

Staff demonstrated an understanding of consent and the MCA. One member of staff told us, "We should always give the person the support they need to make their own decision. If they are unable to make the decision, we follow the correct process and make sure any decision is made in their best interests."