Caremark Cheltenham and Tewkesbury

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’s needs were assessed prior to starting their support with the service. People and their relatives were involved in the process. The field care supervisor visited people in their own homes to gather as much information as possible including their medical background, care requirements, identified risks, medicines, routines and dietary preferences.

Referrals from health and social care professionals were also used to inform their initial assessments. The registered managers sometimes found some of this referral information was not completely accurate and they had to quickly adapt people’s care and support arrangements to fully meet people’s needs. They had since developed an assessment process with more comprehensive information gathering from the outset.

Care plans were thorough, informative and person centred. They were reviewed regularly or when needs or circumstances changed. People new to the service received a ‘service user guide’ and a ‘home file’ to explain the type of support they offered, how the assessment and care planning service worked and contact details including the out of hours service. As a result of regular check ins and monitoring it was found the service needed to respond more quickly to new equipment in people’s homes. For example, how to use safely or to make a referral. This now forms part of the weekly meeting checks with senior staff (field care supervisors).

Staff had full access to people's care plans to learn and understand about them and to refer to when needed. Staff told us their voice was listened to when they needed to report any changes in people’s need.

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.

The registered managers attended the Caremark Care Managers and Gloucester Providers Association conferences, where new ways of working, evidence-based practice and new research enabled them to keep up to date.

The registered managers had good knowledge and understanding of current legislation and best practice and were continually updating their own knowledge and practice to disseminate to staff. We saw evidence based best practice was incorporated into people’s care plans. For example, correct moving and handling procedures, sourcing appropriate equipment and posture support.

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.

Staff told us there was very good teamwork at the service amongst all staff. Comments from staff included, “We are a good team”, “I feel well supported by my manager” and “All staff are committed to delivering high quality person-centred care”. Staff had shared access via a secure private social media app to receive updates and new information.

Stakeholder partners were positive about how people were supported and acknowledged the service was able to manage very complex care packages for people with a high level of need.

The registered managers told us they surveyed partner organisations and professionals to gain feedback on how effectively they worked together. Responses were positive, ranging from good communication and strong partnership to well-managed pathways of care. They regularly attended multi-disciplinary meetings (MDT) to collaborate with other professionals to provide good outcomes for people they supported.

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.

The registered managers told us they were developing a reablement style, physiotherapist led service designed to help improve supported people’s overall mobility, strength, confidence and independence.

The service runs a free whole community, monthly coffee morning where a trained physiotherapist carried out chair-based exercises.

A new complex care branch to the service was also under development. An experienced and skilled registered nurse had been employed to create this new service which would support people in their own homes who had additional health care needs.

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 registered managers carried out regular monitoring activities of the care provided to ensure it remained relevant, safe and effective. Telephone check ins, face to face reviews and surveys formed part of the routine monitoring processes, where changes in need could be identified and changes made to care provision to maintain continuous improvement.

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

Staff had a good understanding of the Mental Capacity Act (2005) and had received appropriate training. The provider had a ‘consent to care’ policy and procedure in place which was updated and reviewed. People and their relatives told us the carers were respectful and always asked permission and if it was alright to proceed with the care.

A staff member told us, “I never enter personal space or begin a task without explaining what I am doing and asking for their consent.”

The registered managers were experienced in assessing mental capacity when required and used their own mental capacity assessments and best interests decisions forms in line with the MCA. Information was being found to confirm if a supported person had a Lasting Power of Attorney registered, to involve the right and lawful people in the care planning arrangements. The service did not support anyone in the community who required continuous supervision and control and therefore no Court of Protection Order was required.