Spire Homecare 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 71 (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.

Before starting the service, the provider carried out an assessment of a person’s health, care, and communication needs. For instance, during one assessment, leaders identified the person required support with mobility and daily living tasks. They also discovered other family members might benefit from additional help and signposted them to other services.

The provider carried out an initial assessment of one person’s needs and continued to review these regularly after care began. This included involving the person’s family. This proactive approach enabled the provider to identify additional areas of need and adapt support accordingly.

Staff told us they received information about people’s needs. They explained the new digital care planning system was particularly helpful, as the app provided up-to-date details on the support each person required, their medication, and any changes to their needs. Comments included: “The app tells you everything about that person - before we had to go through paper records.” Others said that initial assessments were valuable because they “helped staff understand the person before delivering care”.

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.

Staff completed regular training in nutrition, moving and handling and dementia to ensure their knowledge was up to date. This meant staff could deliver care in line with national guidance.

Care records included detailed information about each person’s needs, preferences, and the specific support required to meet those preferences. For example, one person’s care plan outlined how they liked to dress, and the support they needed to help them choose clothing that reflected their style. Another care plan described a person’s preferred meal-times and dietary choices, ensuring staff supported them in planning menus that matched their cultural and personal preferences.

We saw examples where care planning documents captured communication needs, such as using a visual board for someone with limited speech. Another person who used a hoist had guidance for safe transfers when mobilising. These personalised details ensured care was delivered in a way that respected individuality and promoted comfort and dignity.

However, people told us they had not seen their care plan since it had been written at the time of joining the service. People said they would like to see it as they felt it would help carers in their day-to-day work, especially new carers in understanding and knowing people. Some people told us they had not had a review from the provider. This meant people were not fully involved in reviewing their care plans, which increased the risk that their support did not reflect their current needs or preferences.

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 joined the service.

We saw evidence of the provider working closely with the adult social care team including social workers, mental health practitioners and speech and language teams. For example, within one assessment of needs, the provider recognised support from the mental health team would help a person. The provider ensured this happened by regularly updating the social worker and requesting further engagement from other services.

Where support from external agencies was required, we saw evidence of good communication and partnership working. Speech and language therapists (SALT), behaviour teams, and the occupational therapy team had engaged with the service to ensure people’s changing needs were assessed. For example, a delegated nursing task had been identified by the provider who took steps to ensure this was organised collaboratively. When the district nursing team did not attend a visit, staff raised this with managers who followed it up.

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 were proactive in identifying changes in people’s health and took immediate action to ensure appropriate support. For example, staff worked with a person to build their confidence to cook meals at home. This meant the person was less reliant on takeaways which they were having every night.

Care records contained details of how to support people and what people could do for themselves. This included people’s abilities with their personal care. People were supported in an empowering way to complete tasks for themselves such as showering, cleaning and cooking. People told us: “I don’t need help with [that], or if I am feeling unwell and need help with [this] then my regular staff are good at listening to me and stepping in when they see I am likely to struggle”.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes for people were positive and consistent and that they met both clinical expectations and the expectations of people themselves.

A person experienced communication difficulties following a medical diagnosis. The provider took proactive steps to enable the person to maintain independence and community engagement. They supported the individual to leave home for shopping and social activities, arranged hospital transport, and personally accompanied them to medical appointments. These efforts helped secure equipment to enhance safety at home.

Recognizing the communication challenges, the SALT Team invited the provider to a collaborative meeting to review the person’s needs. As a result, an assistive technology tablet was provided, which significantly improved the individual’s ability to communicate. The person described the impact on their well-being as “huge,” noting that the device restored a sense of independence and control.

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

Although the provider had documented people’s consent to receive a service the provider could not evidence appropriate procedures for reviewing people’s mental capacity were being followed. For example, some care plans stated people lacked capacity, but no further information was available. Of the 7 staff we spoke to, 5 were unsure who had capacity to consent. Six staff told us information would be in care plans. This meant documentation did not demonstrate people were fully involved in decisions about their care and treatment. We spoke to the provider about this who took steps to add it into people’s care plans.

However, staff told us how they would ask people for their consent. For example, if personal care was required, all staff told us they would ask before providing support.