Coast Community Care

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 remained good.

This meant people’s outcomes were generally good, and most people’s feedback confirmed this.

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 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. Reviews of people’s care and support needs were carried out but it was unclear whether these were done face to face in people’s homes. Reviews were completed but there were no comments or observations from people or their relatives. Feedback from people was inconsistent with some telling us they had been involved in reviews and others saying not. The registered manager told us that reviews were carried out every 3 months or more frequently following any incidents or visits to hospital. Documentary evidence of people’s involvement in these reviews however was not always found. Before people began being supported by the service there was a pre-assessment carried out which did involve a home visit. These assessments were thorough and notes taken formed the basis of people’s care plans and specific risk assessments. The registered manager always made sure they had enough staff available to take on the additional care visits before a new contract began.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People were asked about their likes, dislikes and preferred routines and these were recorded in care plans. For example, some people expressed a preference for either male or female carers and most of the time this was provided by the service. Most people received support from their relatives when arranging health and social care appointments for example, the dentist, GP or occupational therapists. However, in some cases the service supported in making and then attending appointments. A relative told us, “They are able to phone the office themselves. Once they had an appointment at the eye hospital and they supported them to go to the eye hospital with a carer. They are really helpful, she can always ring the office and ask for extra help.”

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 service had a positive working relationship with health and social care partners who worked closely with the service to produce the best outcomes for people. Staff told us that they often met with community nurses, visiting people to provide nursing support and that they understood the importance of their role and how the care staff then provide additional support. The registered manager told us of ongoing work done with the social work team who were providing support to some people. Some people had complex needs and needed regular reviews from social workers who then advised the service of updates, changes in people’s presentation and needs. These professional arrangements made sure that people received the holistic support they needed. Care plans, which included key health and social care summaries and hospital passports for when people transitioned between services, were shared with other professionals as required.

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.Some people lived with diet controlled diabetes but there was no clear instruction to staff about the types of food and drink that were appropriate for people and which to avoid. This was immediately raised with the registered manager and steps were taken to ensure that staff received instruction. Most people received support from family members with their nutrition and hydration needs however staff did support some people with both food and drink preparation and during mealtimes.

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. Systems and processes were in place for some people to monitor known risks however the registered manager did not consistently review these. For example, people’s food and fluid intake was recorded by staff involved in supporting people to eat and drink. However, it had not immediately been identified that a person living with a choking risk had been given an inappropriate food type. Waterlow scores were recorded for some people but there was no instruction to staff about the steps to take if pressure damage was found. All of these issues were raised with the registered manager who began to take steps to rectify these concerns.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff understood the importance of gaining consent from people including those who needed support with decision making. Staff had received training in dementia care and knew people well and the best ways of making themselves understood to people and explaining the tasks they wanted to carry out. A staff member said, “I always ask, always need consent. Explaining what we need to do.” Relatives told us that in most cases they supported their loved ones with decision making where needed but that the staff were helpful, considerate, and supported if appropriate. Within care plans were decision specific mental capacity assessment covering for example, food preparation, consent to personal care and consent to receive support with medicine administration. Relatives and other professionals, as well as the person themselves, were involved in meetings to decide actions and procedures to follow that were in people’s best interests.