Caring Care Limited

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• 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 consistently good, and people’s feedback confirmed this.

This service scored 67 (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. People and their relatives told us they were actively involved in planning and reviewing their care. Care records showed people’s individual needs were assessed in line with their preferences, choices and wishes. One relative said, “When we started the service, a comprehensive care plan was completed with Mum and me, and she was really made to feel part of the process.”

Feedback from staff and leaders confirmed assessments were completed regularly, and the registered manager explained they assessed each person’s needs based on their individual requirements. Care plans were reviewed and updated to reflect any changes, and staff demonstrated a good understanding of people’s needs.

However, some guidance within care plans lacked sufficient detail and was not fully person‑centred. For example, diabetes management plans did not always include personalised information about the specific symptoms a person may display, instead providing general symptoms only. Similarly, assessments relating to skin integrity were not detailed enough and did not offer staff clear guidance on what to monitor to prevent people’s skin from becoming sore. The registered manager took immediate action to improve the detail contained within these care plans.

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.

Care plans reflected best practice guidance, and daily records showed care was delivered consistently. One relative told us, “Everything is good now, it has been for the last 4 months, they give [person’s name] food now and medication, they take time and she has the same carers now.” Partners told us, “The provider demonstrated the ability to support individuals to maintain their health and wellbeing in various contexts.”

Care records showed a range of evidence-based assessments were used, including tools to assess mobility, skin care, eating and drinking and moving and handling needs. The provider had systems which were aligned to the right support, right care, right culture guidance as they supported some people with a learning disability.

The provider worked well across teams and services to support people. The registered manager understood how to liaise with external professionals, and partners reported good multi‑professional working. There was a handover process where important information and changes to people’s care needs could be shared with staff. Managers could also communicate with staff via the electronic care planning system, which meant updates and key messages were shared in real time.

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. The provider carried out assessments on people’s care and health to ensure they could be supported to live healthier lives. Staff understood their role in supporting people’s health and well-being. They supported people with physical, emotional and mental wellbeing. Processes were in place to enable people to make informed decisions around their own well-being needs.Although there was guidance in place for people’s health needs, this was generic and not tailored to the individual’s needs. The registered manager was receptive of the feedback and we saw evidence all care plans were updated post inspection.

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.

People and their relatives told us they were actively involved in the care planning process. Family members said, when the service first began supporting someone, care plans were developed collaboratively with the person, their relatives and the relevant professionals. Partners described, as part of the reablement pathway, the provider regularly reviewed and adjusted levels of support. This was completed in coordination with commissioning teams, occupational therapists and social workers to ensure care remained safe and appropriate to people’s changing needs.

The registered manager explained the service used a live dashboard system to monitor people’s daily nutrition and hydration. Where the system identified any concerns, these were followed up promptly and monitored more closely to maintain people’s wellbeing and improve outcomes.

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

Systems were in place to obtain consent from people to provide care and support. A mental capacity assessment policy was in place and staff had been trained on the Mental Capacity Act 2005 (MCA). Mental capacity assessments had been completed to check if people had capacity to make certain decisions. However, where people were deemed to have capacity, we found relatives were signing on behalf of that person. We also found some mental capacity assessments missing in relation to certain decisions such as cameras in people’s property and some assessments were not decision specific. The registered manager took action, and we saw evidence all relevant assessments were in place post inspection.