Paradise Hope Ltd

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 the same. 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.

People’s needs were assessed before they began receiving care, and further assessments took place when their circumstances changed. Plans of care demonstrated, and people confirmed, they were involved in the assessment and the planning of their care. One person told us, “My son and I dealt with the referral process, and it went very well.”

When assessments were completed care plans were created with the emphasis on personalised care. They were written from the perspective of people and those important to them. They recorded people’s wishes, how care arrangements were arranged, and were designed to be delivered for people to fulfil their needs and wishes.

Staff confirmed people’s care plans reflected their needs and wishes and they had ready access to them. They also confirmed people had copies of these within their homes.

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 were supported and trained where appropriate by relevant clinicians.

Assessments of people’s risks were recorded. People had been consulted and risk assessments were detailed on known or potential risks to them such as, for example, a Percutaneous Endoscopic Gastrostomy (PEG). A PEG allows people to receive nutrition through their stomach if they have difficulty swallowing or cannot get all the nutrition they need by mouth.

Staff were trained by clinicians to undertake the monitoring of a PEG. There was reference of what action they should immediately take if they identified any concerns such as infection. This included contact details of health professionals who were to be contacted to review any concern staff identified so prompt action could be taken.

People’s views were sought to ensure treatment was in line with their wishes and they told us staff provided good quality care. Where people’s fluid and nutritional intake required monitoring for conditions such as diabetes staff told us they kept accurate and contemporaneous records.

One person said, “I am diabetic. The carers always ask if I have had my breakfast as they come a bit later in the morning. They make sure I have enough to drink when they are here and make drinks for me before they leave.”

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.

The registered manager and staff knew people well, including their life history and experiences and what and who was important to them. Staff shared relevant information and worked in partnership with families and external health and social care professionals.

Managers led by example and provided support to their staff team. Staff supported each other well, working flexibly between them. Staff told us they worked within a consistent team and were supportive of each other and there was evidence of good communication throughout the service.

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 understood people’s needs well and provided support in a proactive and personalised way to manage and monitor their health and well-being. This helped people maintain healthier lifestyles, stay connected with those important to them and remain as independent as possible.

One person said, “They are very flexible which is very helpful. If I ever want to change a visit they are very accommodating and helpful. Earlier this week I had to go somewhere else for another appointment and they just worked around it.”

People were overall monitored effectively. Their outcomes were positive and consistent, and they met their expectations. However, we identified one anomaly between people’s experience of, and the services processes, for reviewing their care needs.

Not everyone we spoke with said they had a formal review of their care, or it had not been undertaken for some time. One person said, “They [staff] follow the care plan to the letter, but it has not been reviewed for some time now although I have no concerns”. Another person said, “I was involved with setting up the care plan, but I don’t know about any review.”

We spoke with managers who told us, “A 6 week review after care begins is carried out and thereafter annual reviews unless there is a change in people’s needs which triggers an earlier review. Outcomes of reviews are then updated on our system and staff have access to them. In addition, we have a ‘whole staff group messaging system’ in place to ensure all staff are aware of any changes.”

Following the assessment managers provided us with some evidence reviews were undertaken in line with their policy. However, based on some people’s feedback clarification and communication of the process between people and the service required some strengthening to ensure the review process was fully effective.

Staff said the care plans held within portable devices continually reflected people’s needs and were updated promptly and accordingly following any change.

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

People’s consent to care was consistently sought and respected. One person said, “They [staff] always ask my consent before they do things for me.”

Staff we spoke with were able to clearly describe how they gained consent from people. They explained how they asked for people’s permission before providing support, how they responded if someone refused care, and when they would escalate concerns to senior staff. One staff member said, “I seek consent from people before we do anything. If they decline I would never force them. I always record if people decline and inform the office.”

Documentation relating to consent followed good practice. We saw evidence initial assessments and care plans were signed and consented to. People who might not have the mental capacity to consent to their care plan, mental capacity assessments were undertaken. These assessments were detailed and decision specific and people and those acting or advocating for them were involved. This meant the provider was applying the principles of the Mental Capacity Act (MCA) were followed.