Hartley Locums

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 provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, and wellbeing with them. People and their relatives were positive about how needs were assessed. One relative told us, “Before [staff] started giving care, [senior staff] came out to discuss the care [person’s name] wanted.” Another relative said, “[Staff] came and did an assessment. It was a breeze. They asked what type of personal care she might want and gender of staff she preferred.” Staff told us the assessments undertaken by senior staff provided them with the information they needed to provide good care to people from the point they began to use the service. People's needs were reassessed as they changed. One relative said because of this, “[The care] has been absolutely brilliant, and staff are responsive to [person’s name] changing needs.” People’s assessments identified their medical history, what physical assistance and well-being support they wanted and if other people had legal authority to make decisions on their behalf.

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. Some people managed their own meals, drinks and snacks independently, or with support from their families. Other people told us staff supported them to have meals and drinks of their choice. People told us staff knew if they required any nutritional supplements and encouraged them to have enough to drink. One relative said, “[Staff] make [person’s name] comfortable before they leave and give them a flapjack and a drink.” Staff gave us examples showing how they escalated any concerns they had to other health and social care professionals, should people regularly decline food, or not have enough fluid to remain well.

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. People were supported by staff to access additional help when they wanted it and staff worked together to make this happen. Relatives told us Hartley House staff liaised with them, or directly contacted other health professionals, when people wanted support from other health and social care organisations. A health and social care professional told us Harley House staff worked well with their organisation. The health and social care professional gave us examples of effective joint working undertaken which had enabled one person to swiftly receive care. The health and social care professional said, “They [staff] are excellent - very responsive to calls and emails and they kept me fully updated.” Staff understood the importance of communicating essential information, such as the medicines people were prescribed and had been administered, to other health and social care professionals. Staff gave examples showing how they provided emergency services and other health and social care professionals with the information required to help to care for people. One staff member said, “We have a list of medicines and care plans in [people’s] homes and on our [electronic care recording device]. Ambulance crew always take verbal information from us.” The staff member explained Hartley House staff worked together in emergency situations, so all people would continue to get their care as assessed an planned. The staff member said following a person experiencing a fall, “[Senior staff] sent out another carer to stay with person.” This enabled the person experiencing the fall to be supported and the staff member able to continue with their scheduled calls, with minimum disruption to other people. Staff gave examples showing how they had advocated on people’s behalf to help to obtain the equipment people needed for their care, and made referrals to occupational therapists and physiotherapists, so people would have access to the specialist advice they needed. Systems were in place to update staff about people’s changing needs. One staff member told us staff teams were able to work effectively together because the flow of information across teams was good. The staff member explained in addition to discussions at staff meetings, and where information needed to be promptly communicated across teams, “We use a group chat to update each other.”

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. People told us staff monitored their health and escalated any concerns. One person told us, “Staff are very good at spotting if I am not well. I am a bit reluctant [to call the GP], but they [staff] have got my GP to come out to me.” The person said swift action by staff and their GP had led to a reduction in them being admitted to hospital. Relatives were complimentary about the way staff monitored their family members health needs and supported them to maintain their health. One relative told us, “Any changes in health they are quick to respond. I can ring and ask them to help for advice.” Staff explained how they had supported people when their health had declined. Staff told us this involved them working with people, their families, and other health and social care providers, so people would have prompt access to the healthcare they wanted, so they would remain well.

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 were positive about the impact of their care. One person said swift action by staff and their GP had led to a reduction in the number of times they had been admitted to hospital. A relative told us their relative had spent time in hospital. The relative said their family member’s wish to return home as soon as possible was supported by staff, who swiftly arranged the extra care their family member needed, to enable them to return home safely. Staff gave us examples of improved health outcomes people achieved, such as increased mobility and the maintenance of good skin health. One staff member told us, “Also you document how much they have eaten and drank. You need to keep an eye on [fluid] output, as it lets you know if the person is poorly or not. If [people’s] health dips, you ring the office and tell the family.” Staff also checked on how anxious people were and worked with people’s GPs, so people would experience improved well-being.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. However, the process for assessing people’s capacity to make some decisions and recording of decisions taken in people’s best interests needed further development. People told us staff asked if they wanted to receive care before starting to provide this. Relatives were positive about the way staff listened to their family member’s decisions. One relative told us, “[Staff] check and they listen to [person’s name].“ Another relative said, “[Person’s name] always consents, because the staff are so nice and are always so happy and make [person’s name] feel at ease.” Staff understood their responsibility to getting people's consent before caring for them. One staff member told us, “You try to be friendly and encourage [people]. If they don’t want to have a shower, we won’t push, you mention it on the group chat for the next carer to try later.“ People's care plans prompted staff to seek people's consent before providing care. People’s assessments confirmed if any other person had the right to make some decisions on their behalf. However, decision specific capacity assessments and recording of decisions taken in people’s best interests were not always in place, where people lacked capacity to make some decisions. The registered manager took action during our assessment to address this.