Amplelime Healthcare Limited

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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 changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 50 (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 and their relatives told us they were involved in the initial assessment and development of a care plan when people started using the service. A relative told us, “Yes, we had an assessment. The care plan contains information about [person’s name] needs. I have seen it and there is a copy kept in the house.” Staff told us they used the information in the assessment and peoples care plan to understand people’s needs and provide their care. The registered manager told us care plans and assessments were electronically completed and gave staff information on how to meet people’s needs. They explained they had identified a need to make improvements in this area and had invested in a new system which would go live in the next couple of weeks.

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 practice. The provider told us the assessment and care planning system used best practice tools to assess risks to their safety. We saw this included risk assessments to maintain people’s skin integrity and tools to monitor this. Staff understood how to use the tools and could describe how this supported them to deliver evidence-based care. People and their relatives told us staff helped them to maintain their nutrition and hydration. A relative told us, “The staff support [person’s name] with meals and drinks. They make sure their fluid intake is right.”

The provider did not consistently ensure staff understood how to support people in line with their assessed needs and care plan. We received mixed feedback about how well staff understood how to support people. Most people described being supported by a regular team of staff who understood their needs and how to meet them. However, some people said staff did not always know how to support them. The provider told us the electronic care records were used to ensure all staff were up to date on information about people’s needs. We saw staff used the electronic record to read what people needed and document the care people had received. Staff told us they always read what had happened in previous calls to understand how people had been and see if anything had changed. We saw where changes had occurred these were documented in people’s care notes and care plans were updated.

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 and their relatives shared mixed views about how staff understood and supported them with their health needs. One relative told us, “The staff have had advice on how to support [person’s name] to use the toilet from a continence advisor.” Whilst other people and their relatives said there were some staff that did not seem to be aware of people’s health needs. Staff told us they understood people’s health needs and could give examples of how they supported people to maintain their health. One staff member told us how they worked with a district nurse to support a person with catheter care. The registered manager told us where people had specific health needs these were considered as part of the assessment and care planning process. The care plans we reviewed had information about people’s health needs such as diabetes and where needed people had referrals made to other agencies, for example where someone had experienced a fall they had been referred to a falls service.

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. The provider told us they carried out regular reviews of people’s care and records we saw supported this. People and their relatives confirmed reviews took place and there was regular monitoring of peoples care delivery in place. A relative told us, “They monitor [person’s name], the registered manager contacts us to discuss this and they come to calls.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People and their relatives told us staff always sought consent. A person told us, “Yes, they ask, shall we? They will not just do things without asking.” Staff told us they had received training in the mental capacity act, and they understood how to apply the principles. The registered manager told us they undertook mental capacity assessments and documented decisions taken in people’s best interests in the care planning system. Records showed where people may lack capacity to consent this was considered, and an assessment was carried out when needed.