Care at Home Services (South East) Limited – Eastbourne, Hailsham and the Weald

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 consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The manager made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. An experienced member of staff was responsible for the pre-assessment process. Before people started using the service, paperwork was reviewed and a home visit took place. The person, their loved ones and where appropriate other professionals, were present at the meeting. All aspects of their support needs were discussed and it was decided whether the service had the staff with the right skills, training and experience to meet their needs. Risks were identified and documented. From this initial assessment a computer program was used to generate a care plan. Risk assessments and where appropriate mental capacity assessments were populated. 2 weeks after the start of a person being supported, the assessor visited the person again to make sure everything was in place and was working for them with their needs being met. Regular reviews took place after this and where people’s support needs changed then care plans were reviewed and updated. People and their loved ones all confirmed these processes and visits and told us how thorough and supportive they found the visits. Comments from people included, “Helpful, kind and patient. They came out to the home and we had a meeting,” “They came to the house to tell us what they could do to help and assessed her needs” and “They do try to listen to her but she has dementia. They came to the house and explained what they could offer.”

The manager 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 able to make decisions about their care and how they wanted to be supported. This was documented within care plans so all staff were aware of people’s preferences and preferred routines. For example, people were given a choice of male or female carers and were encouraged to achieve daily goals and targets. Although the timing of care calls was fixed, if people had appointments or social engagements there was some flexibility with timings of calls. Care plans detailed if people had allergies, required certain diets or food preferences, or were susceptible to pressure sores. A recognised measure of susceptibility to pressure sores, The Brandon Scale, was used for some people and this was recorded within staff daily notes to minimise the chance of sore areas developing.

The manager 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. Positive lines of communication had been established with other health and social care professionals which resulted in people getting any additional support they needed. Several people lived with dementia and staff told us how they sought advice and support from other professionals to help them provide the best care. Relatives told us about the joined up approach provided to support their loved ones. One told us, “They have a Dietician that comes and an Occupational Therapist and a nurse to change her Feeding Rig and catheter. They all work well with the care staff.” If people needed to attend hospital, a 1-page document could be printed from their care plan which provided key information about the person’s medical history, current medication and current presentation in terms of their general health.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives. Some people were supported with their nutrition and hydration needs. The Speech and Language Therapists (SaLT) provided specialist support and advice for some people and staff helped people with preparing appropriate meals and then supporting people to eat. Staff had received the appropriate training and knew the steps to take in the event of a person choking. People not needing specialist support told us that staff would always help if they were asked or if they saw a need. A person said, “They will do me sandwiches or heat up a microwave meal if I ask.” Another added, “They still take the time to chat to me-which I like and although I can do my own food they will do me a sandwich.” A member of staff said, “Encourage to eat and record what is provided. Some have ready meals and I always give a choice.”

The manager 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. Staff knew people well. Staff were able to detect differences in people when they were feeling less well but unable to communicate with staff. Staff knew the importance of escalating any concerns they might have about people, declining their medicines, not eating and drinking or generally presenting as unwell. The manager was committed to making sure people led their best lives possible, receiving prompt and appropriate support from the service and other professionals.

The manager told people about their rights around consent and respected these when delivering person-centred care and treatment. Some people needed support with some day-to-day decisions relating to their care and support. Staff had received training in dementia care and understood the importance of gaining consent from people before carrying out certain tasks and activities. A staff member said, “I try and make them relaxed and explain what I need to do. Relatives can be helpful. No one size fit all with dementia, everyone must be treated as an individual.” A relative told us, “They are safe and very well looked after. They have dementia and they all seem to take their time with them and know when to coax them, they know what they are doing.” Care plans described the level of support people needed and gave instruction and advice to staff about decision making. A section on control measures described specific help that might make things clearer to people for example the use of visual or hearing aids.