Look Ahead Domiciliary Care (Hertfordshire)

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

This service scored 62 (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 assessed and reviewed their health, care, wellbeing and communication needs with them. Where people had moved from one service to another the management and staff team set up a detailed transition plan which allowed staff to build up a good relationship with the person to understand how best to support them. Professionals shared positive experiences of this, one professional said, “I witnessed them working with the ward staff and directly with the service user on many occasions and did not see any negative interaction between the staff team and the service user. The staff used the communication style handed over to them from the ward team to good effect and built a good rapport with the service user. They engaged the service user well in his preferred activities.”

The provider planned and delivered people’s care and treatment, including what was important and mattered to them. Staff and people worked together with professionals to support them with their health and wellbeing needs, however professionals elt in some circumstances staff needed to be more empowered to be involved in conversation relating to people’s health needs. One professional said, “I do believe that from the manager’s side, the client’s wellbeing and physical health is being considered, although I would like to see more of this from frontline care staff.”

People had relationships with people that was important to them. People said they saw their relatives and were involved in the care they received.

People were supported by staff who knew them well. Staff were able to describe what was important to the person and gave examples of how they adapted the way of their support to meet the person’s needs.

People were supported by staff who actively involved health professionals when people needed them. Staff described what they would look out for if the person was in need of health intervention.

People were not always supported in a positive way when their wellbeing was affected. We found examples of where a staff team had worked with an individual to achieve great outcomes for themselves, however this did not seem to be the experience that everyone had when being supported by the provider.

Care and support plans failed to reflect people's aspirations and future goals or focus on people's quality of life outcomes. This was evident when observing staff taking an active role in people's day to day life and not encouraging independence. For example, staff were doing household chores and making drinks without involving the person.

People we spoke with felt their social needs were not being met. People said they lacked the opportunity to go out as they wanted to, records confirmed this.

People’s care plans identified some goals, however there was not always clear dreams and aspirations identified.

People were not always empowered to make their own decisions about their care and support. Records showed that staff were not always actively encouraging people to be involved in their care and choices were not always offered. We found examples where one person did not leave their house in a number of days.

We did, however, find that in one circumstance the person was supported to express their wishes, and although there were restrictions in place this was highlighted in the person’s best interest and the staff team were reviewing this regularly.