Elite Homecare

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 46 (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 always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

A review of a sample of people’s care documentation demonstrated a lack of assessments and effective reviews to consider the person’s health, care, wellbeing, and communication needs, to enable them to receive care or treatment that has the best possible outcomes. We found no evidence within care documents people had been fully involved and consulted in their assessments of care. We were not assured staff conducting assessments were appropriately trained to do so. Appropriate assessments were not always carried out in a timely manner, and staff told us care plans were not always in place prior to staff commencing with care delivery.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We were not assured the management team had up-to-date knowledge on current good practice and standards, relevant to their service. We did not see where the provider’s systems ensured staff were up to date with national legislation, evidence-based good practice and required standards. We saw no evidence nationally recognised tools had been appropriately used to assess and monitor people’s needs or risks.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The management team told us it was problematic to take on packages of care for people who had been discharged from hospital on the same day as the care package commenced. They told us information was not supplied to them in a timely way. Staff told us they would sometimes arrive to provide care and support to a new person and no information about their care needs had been completed.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

We found no evidence the service focussed on the early identification of risks to people’s health and wellbeing or how to support people to prevent deterioration. We were not assured staff were sufficiently trained to ensure they were able to have good knowledge of relevant health care concerns, how to identify them in the people they supported and how to respond. For example, how to recognise a problem with catheter care.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Records to monitor people’s health and care needs and treatment were not robust. Daily records were not always signed legibly or comprehensively completed, for example, we found a gap of 3 days recordings for one person who was not absent from home during this period. Care plans did not include information about people’s goals or outcomes around their health and care needs, for example, improvements in health and mobility after an illness or operation.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The management team told us there was no-one receiving care who had a dementia diagnosis; however, staff told us about two people they supported who had dementia. The management team and staff did not demonstrate an understanding of consent in relation to people with dementia. The management team did demonstrate their knowledge of Lasting Power of Attorney (LPA) and the legal safeguards around this process. Staff told us if people had dementia, they would ask family to make decisions on their behalf without any consideration to the Mental Capacity Act 2005 (MCA). We found some people’s paperwork sections were signed by family members where it was unclear if they had the authority to do so.

In relation to the delivery of care, staff told us they always asked consent when providing care; however, they were not able to describe what they knew about the MCA. People we spoke with told us staff would ask consent before providing care and raised no concerns with us around consent.