Chenai Holistic Home Care Agency 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 good. At this assessment 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 42 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

We were not assured assessments were completed appropriately as information within partner referrals had not been fully explored to ensure people’s needs could be suitably met.

The people and relatives we spoke with gave examples of where their needs had not been met and the impact this had on them. A relative told us, "Assessment was done in hospital, so I thought they would be out again to check at home but apparently not," Another relative said, “[Family member] is not getting what they need or deserves with care."

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

Information recorded within care plans related to people’s care and treatment in line with best practice did not always match the experience of people and relatives we spoke with. A person told us, “I have to repeat instructions every time because they don’t seem to understand anything." A relative said, “They don’t adapt to what [family member] needs; they just stick to their routine.” Another relative added, “It is more difficult having them than not having them sometimes I feel."

People’s nutritional needs were recorded within care plans, however again we received mixed feedback about people’s experiences. A relative told us, “[Family member] wasn’t getting food till late, which is bad as they are diabetic." Another relative said, “They help with anything. The dietician is here now, and they’re discussing it with them."

The provider did not always work well across teams and services to support people.

Whilst the provider told us people received care from consistent staff, the feedback we received did not support this. A person told us, “There are always a few problems when my [usual staff member] is away.” A relative said, “Different carers do things in different ways, so there's no consistency."

Whilst most staff were positive about teamwork, others felt call scheduling impacted on care delivery. A staff member told us, “I usually support around 3 to 4 clients in the morning. The schedules are planned well, giving me enough time to provide proper care and make sure each person’s needs and preferences are met.”

However, another staff member said, “We are frequently understaffed, leading to rushed visits and clients not receiving full care.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People’s care plans required further detail around individual health conditions including signs of deterioration and what action staff should take in response to these signs. Whilst some guidance for staff was available some information was generic, or not available and did not always reflect how the person was impacted day to day in relation to their conditions. For example, there was no information related to how people living with dementia might be impacted day to day and how staff could support them. A relative told us, “[Family member] has dementia, and they’re just not trained to deal with it at all."

The provider did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Whilst we identified records which indicated people’s care was monitored. People and relatives experience did not indicate when concerns were raised, the provider used this information to continuously improve outcomes. They did not ensure that outcomes were positive and consistent, or that they met the expectations of people themselves.

A person said, "I have to explain my routine every time a new carer comes." A relative told us, “They don’t communicate well with each other, so important details get missed."

The provider had not consistently recorded people’s legal consent to care and treatment.

Mental capacity assessments within people’s care plans were unclear and were not always completed in line with The Mental Capacity Act 2005. For example, it was recorded a person did not have an impairment of the brain, indicating there would be no reason to complete an assessment. However, the assessor continued with the capacity assessment. Another person was recorded as having capacity, but their consent form was signed by a relative without a reason why.

During the assessment we received concerns identified by people and relatives related to consent. A relative said, “They will suddenly do spot checks and turn up and randomly ask how [family member] is and this really concerns [family member] and us for that matter."

Staff had received training in relation to the Mental Capacity Act. A staff member told us, “I never presume people do not have capacity. I still have to obtain their consent to what I am doing. I will always ask a person if what I am doing or about to do is ok.”