Choices Homecare (Rotherham North & Doncaster)

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 54 (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. Improvements were required to ensure people’s needs were assessed in a timely way. Reviews of people's needs were not consistently undertaken. We found gaps in care reviews, and we could not be assured pre-assessments and care plans had been formulated at the start of care, due to a lack of evidence provided during the assessment. Care plans contained conflicting and missing information. For example, one person’s plan did not contain details about their diagnosis of a learning disability or how this affected them and the support they needed. A relative said, “[Name] has had a review this year. They did not have a review last year. They put it down to staff changes as the reason why they could not do the review.” A person said, “My care plan needs changing. I can’t remember the last time it was updated. The staff struggle sometimes to do everything. They do what they can. I can’t tell the last time my hair was washed.” Whilst another person said, “I have a care plan which is reviewed regularly.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People’s care plans were not always accurate, complete, or up to date and did not consistently reflect evidence‑based and best‑practice guidance. This meant staff did not always have clear or current information about how to support people with their needs. Although no harm was identified, these recording failures increased the risk people may not always receive care that fully met their assessed needs.

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. Staff did not consistently work well together. Records highlighted concerns about staff culture and poor teamwork, which increased the risk of inconsistent support for people. A staff member told us, “The communication between the staff is poor, we will ring the office to let them know about changes such as medication and they don’t tell each-other. There is no point reporting things to 1 manager as they don’t listen.” Staff appropriately sought support from external healthcare professionals when needed, such as contacting people’s GPs and emergency services.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Whilst we found no harm to people, care records required improvements to ensure they contained robust information about people's health needs. For example, 1 person had a diagnosis of diabetes and there was little information about how staff managed and monitored this condition. Another person had a diagnosis of leg oedema and there was no information about how staff monitored this.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. Some improvements were required to ensure care records contained enough information about people's future goals and aspirations. Whilst some information was in place about people's future outcomes, these were generic and lacked detail about people's wishes.

The provider told people about their rights around consent and respected these when delivering care and treatment. People had their capacity assessed, and where able to people had signed to consent to their care and treatment. People told us staff sought their consent. A person said, “If staff need to share my information, they need my consent.” A relative said, “They [staff] will tell [name] what they are going to do. Staff will use the food chart to show [name] what they can have for dinner.”