Private Home Care UK Limited (Leicester)

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.

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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, well-being and communication needs with them.

A person-centred approach to care was embedded across the organisation, which included the assessment and review of people’s needs, with a particular focus on people’s protected characteristics as defined by the Equality Act. The assessment process was effective in assessing people’s needs and reviewing them to ensure people’s care, communication, treatment and health needs were met.

Communication was a key element of the assessment process as the service supported people from diverse backgrounds, which meant needs around cultural diversity, gender sensitivity and language were essential to ensure people’s needs could be met.

Family members told us, staff had multilingual skills that enabled a better fit with the non-English languages spoken by some, which meant they understood the cultural, religious and dietary needs of people. A family member said, “My [relative] understands, English, Hindi and Gujarati, staff understand her. The carers know our culture.”

A family member spoke of staff interpreting and understanding their relatives’ gestures, body posture, smiles and face movements. They said, “Staff communicate with my son even though he can’t speak. They know what he wants and can read his moods.”

People, and their family members where appropriate were involved in the assessment and review process. A person told us, “Staff asked about my needs at the first visit. Two people came from their office to do an assessment. It was written down and I signed it. Recently they did a review, and my son checked it for me before I signed it.” A family member said, “The care manager came. We had a long discussion that was more than two hours long. We went through everything, including what they could provide and emergency contact numbers.”

People’s assessment records provided a clear overview as to their health and care needs and detailed the role of staff in providing support and care. People and family members told us staff provided the care and support as agreed.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them, including religious and cultural needs. They did this in line with legislation and current evidence-based good practice and standards.

The provider used recognised assessment tools in line with legislation and current evidence-based good practice and standards. The provider sought people’s views and that of their family members to ensure, where required, meals were provided in line with their needs and with consideration to people’s cultural needs.

Staff were knowledgeable as to the importance of people’s dietary needs during religious festivals, for example during Diwali the sharing of specific foods and sweets. People were supported to observe Ramadan, with adjusted care visit times to accommodate fasting and prayer schedules.

People’s records provided clear guidance as to people’s dietary needs, which met their cultural and religious needs. A family member told us, “Staff understand her culture and faith and understand she is pure vegetarian; staff are all Gujarati speaking and brought her sweets for Diwali.” Peoples’ records included clear guidance where people’s dietary needs had to be tailored to their specific needs, for example where their dietary intake was provided via a nasogastric tube.

Dependent upon people’s assessed needs, staff where required would support people with grocery shopping. A person told us, “Staff take me shopping once a month, in a taxi.” Another person said, “I go shopping on Thursday with carers.”

The registered manager informed us people’s care plans were regularly reviewed with input from healthcare professionals. Reflective practice was encouraged in staff supervisions to ensure new approaches were understood and applied effectively, and professional guidance for example from NICE (National Institute for Health and Care Excellence) and NHS (National Health Service) were integrated into training and care protocols.

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.

People’s care records were accessible to both staff, people who use the service, and where appropriate their family members. Staff supported people to access and share information with health care services. People’s records in some instances included information to be shared in an emergency or in the event of their being admitted to hospital.

The registered manager told us they had maintained strong links with GP’s, community nurses and social workers to support in the co-ordination of care, whilst managers attended integrated care system meetings to strengthen partnerships and joint working.

Several people and family members spoke of how the provider and management team had guided, informed and advised them in how to access funding through an assessment of their needs following a change in their health and or well-being, including when their needs either increased or decreased. Partner agencies told us the provider alerted them in the event people’s needs changed, where their care was funded by the local authority.

The provider supported people to manage their health and well-being 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.

The ethos of the service was to facilitate people remaining in their own homes, by encouraging and supporting people to maintain their health and, where practicable, increase their independence. A family member told us, “The carers encourage her to do physical exercises and motivate her, they advise her to keep walking with her walker.”

People’s care plans explained the support people required to enable them to stay well and access healthcare services, where necessary. People with specific medical conditions had detailed information within their care records which provided guidance for staff as to how this affected the person and how best to support them. For example, a holistic package of tailored care and support was in place to support a person with all aspects of their life, with consideration to several health conditions.

Staff had undertaken training in topics which enabled them to identify and support people to manage and respond to health concerns and used a well-being checklist to monitor people’s hydration, nutrition, mobility and mood.

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

Peoples’ comments, and that of their family members acknowledged the positive outcomes they experienced as a direct result of the service they received, by reducing social isolation and ensuring effective care. A family member told us, “Staff give her love and that has changed [person’s] life. She has bonded with them.” Another family member told us how their relatives’ repetitive behaviours were approached by staff, in a calm and accepting manner, encouraging them to divert to other activities they enjoyed.

People’s care records included their goals and aspirations, and all aspects of people’s care and support was regularly reviewed with the person, their family members and amended to reflect people’s changing needs. A person told us, “We have a care plan, and a family member signed it. They came to check up on health needs at a review and check on adaptations and health issues.”

Senior carers we spoke with told us they carried out the initial assessment of people’s needs, and introduced staff to people, and their families, and shadowed staff where appropriate to ensure staff were providing support and care in line with a person’s assessed needs. Staff confirmed care plans were developed by office-based staff who completed them based on the outcome of a person’s initial assessment. Staff told us care plans contained enough information to know what and how cared needed to be provided.

The registered manager informed us people’s care outcomes were continually monitored and reviewed using tools, for example, falls, and people’s weight, along with feedback from people, their family members, staff and external professionals.

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

The provider understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires, that, as far as possible, people make their own decisions and are helped to do so when needed. Where people lack mental capacity to make particular decisions, any made on their behalf must be in their best interests, and as least restrictive as possible.

People and family members were fully involved in all decisions relating to their care and support and never felt rushed by staff. A person told us, “Staff ask me first and if I don’t want to, then they respect that.” A family member said, “Staff always ask her, ‘are you ready,’ they don’t ever rush her. They follow her needs.”

Staff had undertaken training on the (MCA) and were aware that all care interactions required the consent of the person and understood the circumstances where people’s capacity could be dependent upon the complexity of the decision to be made. A staff member said, “Everyone can make some small decision.” Staff were aware of the barriers and potential judgements people may experience due to their specific needs around decision making. A member of staff told us, “You can’t assume someone doesn’t have mental capacity just because they have a learning disability.”

People and family members told us staff always knocked on the door before entering their home. People’s care records provided information and guidance for staff on entering people’s homes.