We Do Care (London) Ltd

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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 this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

We did not assess all the quality statements within this key question. We did not identify concerns relating to these areas which we judged as being met at our last inspection.

This service scored 71 (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 monitor and respond to people’s changing needs in a timely manner. One person’s care plan did not reflect the information gathered following a review and changes in their care and support needs. After speaking with the service manager, the care plan was promptly updated.

Care plan lacked adequate information on people’s medicines, health conditions and healthcare professionals involved their care for staff, particularly if they were new, to have a good understanding of people’s needs.

However, people felt that they were involved as much as possible in the care planning process. A relative commented, ‘‘I felt involved. When we needed to change a routine I co-ordinated that. If I want changes I can talk to them. It is added to the care plan.’’

The registered manager told us, ‘’During assessment and reassessment stages, clients are asked if they have any additional communication requirements. If they do, this support is recorded in their care plan, which is tailored to meet these needs. When community professionals are in contact, we flag those additional support requirements to these professionals.’’

An external healthcare professional told us, ‘‘Staff communicate well and do carry out any actions that have been advised.’’

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

We saw that for people who lacked mental capacity to make decisions about their care, the provider had clearly identified their representative including those with Lasting Power of Attorney (LPA). A lasting power of attorney (LPA) is a legal process that allows someone to appoint others to make decisions on their behalf if they had lost the ability to do so.

The provider provided staff the opportunity to complete mental capacity training. Care plan showed whether people could communicate their needs and make decisions about their care. People and their representatives completed consent forms, and they confirmed that staff seek their consent before providing care and support. This helped them make an informed decision.

The provider clearly recorded if a person had a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) order in their care plan to show they had understood people’s choices and wishes.