Help at Home (Danbury Gardens)

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, wellbeing and communication needs with them.

People were fully involved in care planning. People’s views detailing how they wished their care to be provided was documented within their care records and signed by them and a member of staff. A person told us, “I stated at the outset that I only wanted female carers looking after me, and it has been the right decision.” People’s needs were viewed annually or as and when their needs changed. A family member told us, “There are some adjustments to the care plan going on now due to the changes currently happening to [person] and Help at Home make sure my [relative] is included in all that.”

The initial assessment undertaken by the local authority identified if a person met the criteria for receiving care and support, where they do, the assessment was shared with Help at Home (Danbury Gardens). The assessment was only shared when the person residing at Danbury Gardens had agreed Help at Home (Danbury Gardens) were to provide their package of care. The assessment formed the basis for the development of a care plan, involving the person.

People’s individual needs and preferences were detailed within their care records, focusing on a range of factors, including personal care requirements, medicine and health needs, communication and cultural needs. People’s care passports provided a clear account as to the support and care required, the duration and frequency of care calls.

Assessments of people’s needs in addition to personal care considered other aspects of people’s lives, for example, shopping, socialisation and domestic support. Many people were supported by Help at Home (Danbury Gardens) with household tasks, such as cleaning and laundry, and shopping calls to facilitate grocery shopping, and socialisation calls, where staff supported them to access social events organised by Danbury Gardens. A family member told us, “The carers support [relative] with a range of things apart from personal care, they bring meals up, take them shopping and to yoga if they wish to join in.” A second family member said, “My [relative] has 3 regular calls a day for support with personal care; lunch; evening meals and then weekly calls to support with shopping, linen changes, laundry and housework.”

In addition to people’s involvement with care planning, communication was maintained with social workers and family members, along with any health or social care professionals, including G.P. district nurse or mental health team.

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 made decisions as to what they ate or drank, the role of staff was to encourage people to make good choices based on their needs, and to provide support to prepare, breakfast, tea, snacks and drinks where required. A family member told us, “Staff will microwave meal at teatime if [relative] feels like it, they just have to say.”

People’s records provided clear guidance as to people’s dietary needs, including information as to their likes or dislikes, religious or cultural needs, beliefs or health needs such as diabetes. People’s packages of care included information outlining the support they required for meals throughout the day. People who were at risk of malnutrition were prescribed supplements. A family member told us, “It’s getting harder and harder to get [relative] to eat, so they are now on Protein supplement drinks.”

People’s contract with the provider of the extra care housing complex, Danbury Gardens, including the provision of a hot lunchtime meal, served in the restaurant. People’s packages of care with Help at Home, included information as to whether staff were required to support the person to access the restaurant, or collect a meal of their choosing, from the restaurant and deliver it to their own home. A person told us, “I used to get my lunch brought up to me, but that has stopped now. Instead, I go down to the restaurant.”

A holistic approach to care and support was documented in people’s care passports and provided an effective system for people’s care and support to be recorded and reviewed, with staff documenting any changes they noted.

The quality assurance and contracts team provided bulletins containing information relating to good practice, which included vaccination programmes, training and weather warnings, highlighting the potential areas of concern for staff to monitor in extreme hot or cold temperatures when caring for people.

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 and family members told us that where required, staff supported then to navigate access to health and social care services. A family member told us, “My relative is diabetic and prescribed Insulin, there have been meetings recently with the GP to organise a district nurse taking over (administration of Insulin), as [relative] is getting forgetful.”

People’s care records were accessible to both staff, people who use the service, and where appropriate their family members. Staff supported people to access and share information with health care services. People’s records included information to be shared in an emergency or in the event of their being admitted to hospital.

Effective systems of communication amongst the staff team and with external health and social care professionals ensured any changes in people’s needs were shared. Team working was promoted through regular staff meetings, supervisions and appraisals.

Partner agencies told us the provider alerted them in the event people’s needs changed.

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’s needs relating to any support required from the registered manager and staff to liaise with external health and social care professionals was recorded within their care records. People we spoke with told us staff, if required, would contact their G.P. if requested to do so. Family members told us staff were vigilant in identifying any changes in their relative’s health or wellbeing, and with their relative’s consent, contacted the relevant professional. A person told us, “The carers keep an eye on pressure sores for me and will soon sort a GP appointment if something needs attending to.”

Positive and supportive relationships developed between staff and the people they cared for facilitated the provision of good quality care and outcomes. In part this was achieved as people received care from a consistent team of staff who know them well. Staff told us they completed daily notes and reported any changes in people’s health or care needs.

The provider and staff worked well with healthcare professionals, and others involved in people’s care, to ensure they received continuity of care from everyone involved. Staff confirmed they supported people to liaise with health and social care professionals, which included where people found it difficult to communicate with services. For example, a member of staff said, “We would support a non-English speaking person with district nurses or GP appointments.”

The registered manager told us they maintained strong links with a range of health and social care professionals, including district nurses, GP’s, occupational therapists and social workers.In addition, they liaised with pharmacists for support with medication, and mental health and community teams.

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’s comments, and that of their family members acknowledged the positive outcomes they experienced because of being supported by Help at Home (Danbury Gardens), by enabling them to maintain their independence. A person told us, “I much prefer my independence, and the service helps me have that, the main gift of this place is that it has given me my freedom.” A family member said, “If my [relative] wasn’t living at Danbury Gardens with the support of Help at Home they wouldn’t be able to continue to be independent, which is their greatest wish.”

Family members spoke positively of how staff observed and acted, where required, if they noted any concerns relating to their relative’s health and well-being. A family member told us, “The carers know that [relative] has a tendency to depression and occasional delirium, so they keep an eye out for that, and keep me in the loop.”

People’s care records wholly reflected people’s abilities and the importance of maintaining their independence. The care and support provided emphasised what the person could do without assistance and made clear the areas of support that was required. For example, where people received support with washing/showering, the care records detailed what areas of the body the person required support to wash.

People’s care records included clear guidance as to the role of staff in monitoring risk, such as a breakdown in people’s skin integrity, and the action required. A member of staff told us, “We observe presence of red or shiny skin when delivering personal care. I would report this, and make sure it was reported to the GP or district nurses.”

Staff documented the care and support provided in the ‘home care report book’ which referred to all aspects of care and support, including any wishes or comments made by the person, or observations noted by the member of staff. The report book incorporated sections for specific areas of people’s care, to be completed where applicable. For example, medication administration, re-positioning of people to prevent skin breakdown and a record of financial transactions, signed by the person, in the event staff undertook grocery shopping on their behalf.

The registered manager informed us people’s care outcomes were continually monitored and reviewed and that they responded to feedback from people, staff and external professionals.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were fully involved in all decisions relating to their care. A person told us, “Carers are always checking if it is okay to do something. I tell them to just do it, but I understand they have to ask. There is absolutely no pressure to do anything I don’t feel like doing.” People had signed their care records, agreeing to the care and support to be provided. People’s capacity to make informed decisions was considered, and where people chose not to adhere to guidance or advice from external professionals this was documented and supported, and where appropriate shared with partner agencies, including health and social care.

People, and in some instances family members were fully involved in the ongoing review and assessment of their needs. A family member told us, “My [relative] is very independent, but last November I could see they needed some support, so I spoke to adult social care, and now have a morning and evening call to support with personal care, and a domestic support. The carers check they have taken their medication, but [relative] does this themselves.”

Staff had undertaken training on the (MCA) and were aware that all care interactions required the consent of the person. A staff member told us, “I make sure I ask people before I do any personal care, give food or medicines. I wait for their agreement before doing anything. If there is a repeat refusal of food, we cannot force this, but I try different ways of encouraging them to eat.” Another member of staff said, “I don’t think we have anybody who lacks capacity, they can all make their own decisions. I know that I am doing what they want, in the way they want it done.”

The provider understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The 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. Where people lack mental capacity to make particular decisions, any made on their behalf must be in their best interests, and as least restrictive as possible.