Bells Home Care Limited

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 62 (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.

Senior staff assessed people’s needs through initial visits and collaborative care planning. However, 1 person receiving care for over a month did not have a care plan in place, and daily notes were unavailable. This indicated inconsistent practice in ensuring all people have documented assessments. We discussed this with the registered manager who confirmed they had taken action to ensure a care plan was put in place. Family members confirmed that care plans were created and reviewed after hospital stays or changes in condition. One relative said, “The care plan is here in the book. We did a review when [relative] came out of hospital.”

The provider did not always plan and deliver people’s care and treatment effectively. The provider worked with people and their families to ensure they knew what was important and what mattered to them.

There was limited evidence that care delivery aligned with current best practice. For example, risk assessments for flammable creams were missing, body maps were not used for topical creams, and protocols for ‘as and when required’ medicines were absent. Guidance describing food textures and drink thicknesses for people with swallowing difficulties was not appropriately applied in 1 person’s care plan, despite a prescription for thickener. One relative told us, “They are all very well trained, competent staff.” However, the lack of documented guidance and protocols in some aspects of care planning undermined safe and effective care delivery.

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 worked collaboratively and communicated effectively across the team and with external professionals. Health changes were monitored and reported, and people were supported to access healthcare when needed. One relative explained, “We both (them and a staff member) rang the GP on the same day, so that's good.” Staff were described as “exemplary” and “very well trained”, and there was evidence of multidisciplinary working.

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.

Staff supported people’s health and independence. For example, when a person’s mobility improved, their care plan was reviewed to promote independence. People received help with meals and personal care, and staff prepared food based on individual preferences. One person said, “They (staff) make what I ask. They can cook a full meal, so that's good isn’t it.” However, not all health-related interventions were supported by appropriate documentation and risk management.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

Some outcomes were monitored, such as mobility improvements. Staff were proactive in identifying health concerns and liaising with professionals, but care records did not consistently reflect expected or agreed outcomes. People and relatives described improvements in quality of life, such as increased independence and reduced reliance on family carers. One relative said, “We go every day but now there is nothing for us to do and we can just visit, the house is clean and so is [Name].”

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

Consent was sought for all aspects of care and support. People confirmed that care plans were discussed with them and that they had control over decisions. One relative said, “It’s all [Name’s] decisions, they are happy with it all.” The provider had improved documentation of consent since the last inspection.