Princess Homecare

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 remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider continued to be in breach of the legal regulation related to consent to care and treatment.

This service scored 63 (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.

There had not been any new people to the service, but staff told us the provider always assessed a person before offering them a care package. This ensured their care and support needs would be met. Staff told us the assessment included any specific communication needs such as the person’s preferred language. They said records would be provided in an easy read or large print format if needed.

There were regular care plan reviews and relatives were invited to attend if the person wanted this. Staff knew people well and understood their needs. They said any changes would be easily identified and escalated to the provider.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

At the last inspection, there was conflicting feedback from providers and staff about evidenced based care. This was because staff believed the provider’s practice had been established over time, rather than based on current guidance.

At this inspection, a staff member told us the provider was more accommodating and open to new ideas. They had completed the same online training as staff but had not undertaken any training related to their role or the shortfalls identified at the last inspection. This did not ensure the provider was up to date with best practice.

The provider’s website stated people could have a free consultation with the provider’s nutritionist, to discuss and create an individualised eating plan. The website also stated the provider was dedicated to providing advice on types of food which would supplement the person’s diet and keep them healthy. However, the provider was not qualified to do this. Whilst the provider told us they no longer had a nutritionist on the team, the information was misleading and increased the risk of unsafe care.

Nationally recognised tools were used to assess and monitor people’s needs and the risks they faced. The provider and staff understood the importance of good fluid intake and nutrition in relation to people’s health. Records showed people had enough to eat and drink and were supported to have a nutritionally balanced diet.

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.

The provider told us they worked alongside other health and social care professionals when needed to meet people’s needs. Records showed they had recently liaised with the community nurses and occupational therapist. Two health and social care professionals told us the provider was good at gaining advice when they were unsure of something.

The provider and staff told us due to being a small team, people’s needs were discussed daily. They said they knew people well and could identify any small changes in a person. The provider told us staff were excellent at identifying a change in the person’s ill health and escalating their concerns.

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’s healthcare needs had been assessed and there was guidance for staff on what to do in the event of a medical emergency. Records showed staff responded to any ill health in a timely manner. One staff member told us they knew people well so could easily spot when a person was ‘not quite right.’ They said they would flag this with the GP to ensure they were reviewed.

A health and social care professional told us they assumed staff prepared nutritious meals for people, as they had seen them chopping vegetables in preparation.

The provider’s website stated people could speak to their physical activity guru to create exercises which would improve their strength, flexibility and overall wellbeing. However, the physical activity guru no longer worked at the service. This information was therefore misleading and gave the risk of unsafe practice.

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.

The provider told us they held care reviews, and people and their relatives regularly told them they were happy with the service provided. However, the provider did not have a formal system to seek people’s views about the service they received. This did not ensure people’s views directed the ongoing development of the service.

The provider told us they had informed people and their relatives about the inadequate rating issued at the last inspection, but there was no evidence of this. The provider had not documented any of their discussions. This did not show people had accurate information to make decisions about their future support.

The provider was continuing to enable people to live in their own homes, where they wanted to be. They said they had supported one person to become more independent, so they no longer needed the service. One person told us of their appreciation of the provider. They said the provider supported them on each visit and did exactly what they wanted them to do.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. 

At the last inspection, decisions had not been formally assessed in line with the Mental Capacity Act. This was a breach of the regulation, consent to care and treatment.

At this inspection, improvements had not been made. This was because information did not always show how people’s mental capacity to make decisions had been assessed, and assessments continued not to be decision specific. This did not ensure consent to care and treatment was sought in line with legislation and guidance.

The provider had a policy regarding mental capacity, which clearly stated their responsibility and what practice they needed to ensure. However, due to the shortfalls identified, it was evident the provider was not following their own policy.

The provider and staff had received up to date online training on the Mental Capacity Act. However, this had not enhanced their knowledge and understanding or improved their practice.