Lima Homecare LTD

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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 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 assessed and reviewed people’s health, care, well-being and communication needs to make sure support was effective and tailored to each person. Assessments were completed with people and reflected their views and preferences.

People and relatives confirmed assessments were carried out before care started and reviewed regularly, with people’s consent and family involvement where appropriate. One relative told us, “[Relative] had an initial assessment two to three years ago but is reassessed regularly.”

Information from assessments was used to develop detailed care plans covering people’s holistic needs, including physical and mental health, communication preferences, the home environment and personal goals. The management team recognised some records contained duplicated or outdated information and were taking steps to streamline documentation and remove superseded guidance.

Although this did not impact on people’s care, we found some daily records lacked sufficient detail to explain observations and professional decision making, particularly when people felt unwell or care needs changed. Managers acknowledged this and had already reinforced documentation expectations with staff, demonstrating a commitment to improving record keeping and ongoing assessment.

The provider planned and delivered care with people, taking account of what was important to them and what mattered in their day to day lives. Care and support were delivered in line with relevant legislation, national guidance and evidence based good practice.

Care plans reflected current professional guidance where required, including advice from specialist services such as speech and language therapy (SALT) for dysphagia and clinical guidance for long term conditions such as diabetes. Staff understood how to follow these plans and adapt their practice when people’s needs changed. One staff member told us, “We can find any dietary requirements in the care plans, and if anything changes, we report it to the office so the care plan can be updated.”

People told us staff supported their nutritional needs in ways that respected their preferences and routines. One person said, “Meal wise, the carers can make me a sandwich or microwave a meal, no problem. I can eat when it suits me.” Another person told us, “I have one visit in the morning for personal care, like washing me, breakfast and washing up. Breakfast is perfect.”

The provider worked effectively across teams and with other services to support people. Information was shared appropriately so people did not need to repeat their history when moving between services or when additional support was required.

Internal communication systems supported coordinated working. Staff received operational updates through handovers, electronic alerts and meetings, with important information shared promptly. One staff member told us, “Communication between staff and the office is good. If something changes, we are informed by phone or message.”

Staff worked well with external professionals, including district nurses, GPs and social workers. Referrals and escalations were made in a timely way and were clearly documented. External professionals told us the service kept records up to date and shared relevant information appropriately. A staff member said, “Communication with outside professionals like district nurses or GPs is usually good. Within the staff team, handovers are the main way we keep each other informed.”

Records showed clear, consistent documentation and evidence of responsive action when people’s needs changed. This supported coordinated care and helped ensure people received timely and appropriate support.

People were supported to manage their health and well-being in ways that promoted their independence, choice and control. Staff worked with people to maintain their health and, where possible, to prevent or delay the need for additional care and support.

People and relatives told us staff were proactive in recognising and responding to changes in people’s health. This included identifying early signs of deterioration, such as changes to skin integrity, catheter related concerns and signs of urinary tract infections. Concerns were escalated promptly to relevant health professionals and, when required, the emergency services. One person told us, “If I was found to be unwell, they (staff) would contact the relevant people. I also wear a lifeline button.” A relative added, “Carers are good at noticing any potential skin problems.” Staff demonstrated a clear understanding of how to identify health concerns and told us they reported these promptly to ensure people received timely support and treatment.

The provider promoted preventative approaches to healthcare. Staff received regular information and updates, including newsletters, which reinforced good practice such as pressure ulcer prevention. People were supported to access healthcare services when needed, and referrals were made to professionals such as dentists and speech and language therapists to support people’s ongoing health and well-being.

The provider had effective systems to monitor care delivery and quality, which supported positive and consistent outcomes for people. Information was used to identify areas for improvement and to strengthen safe and effective care.

Regular audits of care records, including care notes, medication administration and communication logs, checked that care had been delivered as planned and people’s wellbeing monitored. Any gaps or variances were recorded, with actions identified and followed up. Learning was shared with staff through team communications and meetings. A service improvement plan was used to track actions and demonstrate ongoing quality improvement.

An electronic care records system enabled the management team to monitor care delivery in real time, identify trends and respond promptly to changes in people’s needs. Updates were shared quickly with staff, helping to ensure care remained responsive, consistent and focused on improving outcomes.

The provider supported people to understand their rights in relation to consent and ensured these were respected in the delivery of person-centred care.

People consistently told us staff sought their consent before providing support. One person said, “Carers are always respectful, ask my consent before personal care like a shower and explain what they will do.”

The provider promoted people’s rights under the Mental Capacity Act (MCA). There was clear evidence that capacity was considered on a decision specific basis, and that best interest processes were used when required. People were involved in decisions about their care, with families or others consulted where appropriate. Staff were supported through updated consent documentation, memos and supervision, which reinforced key MCA principles, including the right to make unwise decisions.

We identified an inconsistency in one person’s records where consent documentation had been signed by a relative without clear legal authority. The management team responded promptly, providing assurance that the person had capacity and had requested this. They told us that documentation would be improved to better reflect these circumstances and to ensure wording does not imply a lack of capacity or legal authority.