Premier Care - Halton Branch

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 63 (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 generally made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them, however some information required improving.
People's needs were assessed at the start of their care package; however, information was not always recorded consistently across assessments and care plans. For example, a person's physical and sensory impairments which affected their day-to-day needs, had not been considered within their pressure care risk assessment. This meant the assessment did not provide a complete picture of the person's needs and associated risks.
 

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.
However, records did not always provide assurance that care was consistently delivered in line with people's care plans. We found examples where instructions regarding pressure care, application of barrier creams, nutritional monitoring and repositioning were not consistently recorded. In some cases, care records contradicted other documentation or lacked sufficient detail to demonstrate that monitoring and interventions had taken place as planned. Although we did not identify evidence of widespread poor outcomes, these recording and oversight issues reduced assurance that evidence-based interventions were being applied consistently across all care packages.
 

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 provider described working closely with GPs, pharmacies, community nurses and other healthcare professionals. There was evidence of referrals being made following incidents, changes in health needs and identified risks. Positive outcomes seen in relation to skin care management and recovery following hospital discharge demonstrated the benefits of multidisciplinary working for many people.
 

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.
The provider supported people to maintain their health, wellbeing and independence. People told us staff encouraged them to remain as independent as possible and provided support that promoted positive outcomes. One relative told us, “Doctors have commented on the improvement they have seen,” while another said, “We are very happy with the service and would be lost without it.”
 

The provider mostly monitored people’s care and treatment routinely to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.
We did however find some inconsistencies in records relating to nutritional risks. One person's daily notes recorded no concerns regarding food and fluid intake, despite the same records showing the person had refused meals on two occasions that day. This meant records did not always provide an accurate account of the person's needs or reflect changes that may require monitoring or action.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
People consistently told us staff sought their consent before providing support and respected their preferences. One person said, “In every way they 100% respect my wishes.” Relatives also described staff adapting care to people's individual preferences and involving families appropriately in decisions about care and support.
The provider had policies and procedures relating to consent and mental capacity. We reviewed evidence showing people were asked for consent to care, treatment and information sharing, including the use of accessible consent documentation. Information was available in different formats and processes were in place for recording verbal consent where appropriate. Staff demonstrated an awareness of their responsibilities under the Mental Capacity Act 2005 and understood the importance of involving people in decisions affecting their lives.