Amicable Care 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 our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 54 (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 make sure people’s care and treatment was effective because care plans did not always include detailed information. People’s needs were documented, such as personal care and mobility needs however there continued to be limited information about how to support people to ensure their needs were met.

Care plans included that people needed support with a shower or a full body wash but there was no detail in relation to how to support people to ensure their safety and wellbeing. There was reference made to continence needs in some people’s records however there was no detail on the actual support people needed.

Staff knew people well and were able to talk about how they supported people in a safe, respectful way but these strategies were not documented in care records which left people vulnerable to inconsistent care. This was an ongoing concern from the last assessment and the required improvements had not been made.

The provider did not always plan and deliver peoples care in line with current evidence based good practice and standards.

Staff supported some people with continence care needs and the application of prescribed creams; however, care plans did not detail people’s needs and wishes and risks had not been assessed. The management team were not aware of nationally recognised tools used to assess people’s needs. For example, waterlow, which is used to assess risks relating to skin integrity and MUST which is used to assess people’s nutritional risk.

Some improvements had been made since the last assessment in relation to the recording of food and fluid offered to people, but risks were not assessed. There continued to be no information in care records in relation to people’s cognition. Pressure care training had been completed.

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.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control.

Care records did not always include specific information about people’s health care needs. For example, there was no detail recorded in care plans in relation to how people’s specific health needs affected them. There was no information on the signs and symptoms staff should look for if someone’s health needs changed.

The staff were knowledgeable about people’s health and wellbeing and supported them to maximise their independence, choice and control.

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.

People were not always told about their rights around consent. The principles of the Mental Capacity Act 2005 (MCA) were not fully understood or implemented. The registered manager told us, “I would not feel comfortable doing capacity assessments so I would contact social services and ask for a review if something was amiss. I’m not comfortable making that judgement, I know it’s my responsibility to do it if needed.”

The provider was able to describe the process for completing a capacity assessment and best interests decision, however, they acknowledged these were not documented.

There was some detail in care records about people’s capacity to consent to medicine administration, but these were not always up to date. The registered manager also told us, “Some relatives have signed this as people don’t want to sign documents.” The reason for the relative signing on behalf of the person was not documented.

Staff understood the need to seek consent from people, and to respect people’s wishes.

Policies and procedures were in place in relation to capacity and consent and all staff had attended online training in the MCA