Amber Home Carers Surrey

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Systems were in place for assessments to be completed prior to people’s care starting. People confirmed this happened and told us they were able to contribute to their assessment. One person told us, “They came round after I came out of hospital and asked lots of questions about what I needed. That was before they started visiting.”

Assessment information was gathered from local authority assessments and from meeting the person and their relatives where appropriate. This enabled the service to share a basic care plan with staff with the aim of having a full care plan in place within 3 days of a person’s care starting. A spot check was also completed within the first week to check they were happy and did not require any changes to their care plan. The registered manager confirmed care records were updated regularly as and when people’s needs changed. Any significant changes were also shared with the local authority where they were responsible for funding the person’s care.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. However, we found recognised best practice tools were not utilised to keep people as safe as possible.

Best practice tools to monitor people’s wellbeing in areas including nutrition and hydration, skin integrity and pain management were not used. Whilst we did not identify any direct impact on people’s care, there was a risk that health concerns may not be identified in a timely manner. The registered manager told us the electronic system being used had the facility to incorporate best practice systems into people’s care plans. They assured us these would be incorporated into people’s care plans and reviews going forward.

Records showed that staff responded to changes in people’s needs when issues arose through referrals to external professionals.

Following our assessment the provider told us they were in the process of reviewing the most effective ways for the service to utilise best practice monitoring tools.
 

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.

Processes were in place to support staff sharing information regarding people’s needs. Staff received guidance on people’s needs before they started to support them. People, staff and families were then involved in sharing additional details regarding people’s preferences to be added to their care plans. In addition, regular team meetings were held with good staff attendance. This enabled staff to discuss concerns and share information regarding people’s care and support. Meetings minutes showed this information was acted upon, with referrals being made to health and social care professionals as required.

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 service had systems in place to monitor and review people’s health and well-being and act on concerns identified. Examples included working with a person, their family and external professionals to provide adaptations and equipment to support them. This resulted in the person no longer experiencing falls and being able to remain safely in their home. In another instance, a person was experiencing a specific health condition. Staff received additional training which meant they were able to continue supporting the person whilst reducing the impact on health resources.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were recorded and agreed with the person.

Records showed that areas of people’s care which needed monitoring were not always reviewed. This included the monitoring of people’s diabetes checks, repositioning to maintain people’s skin integrity and catheter care. This information was not clearly recorded to ensure the required checks were being completed and there was limited evidence these areas of people’s care were reviewed. This meant the provider was unable to assure themselves people were receiving their care in line with their needs and outcomes.

In other areas we found the service showed a flexible approach to improving people’s outcomes. Staff identified one person was not eating well and had lost weight whilst in hospital. An additional care visit was arranged at lunchtime each day to encourage the person to eat. Over time the person gained weight and was able to reduce the need for this additional call.

The provider did not always tell people about their rights around consent and people’s capacity was not assessed in line with the Mental Capacity Act 2005 (MCA).

Where there was information to suggest people may lack capacity to make individual decisions regarding their care, the provider had not completed capacity assessments in line with the MCA. No information was available to determine that decisions made regarding people’s care were in their best interests. This was of particular concerns where people received extended periods of 1-1 support with little information provided regarding how this should be provided. This meant there was a risk people’s support would not be provided in the least restrictive manner.

On a day-to-day basis people and their relatives confirmed that staff always asked for their consent before providing care. One person told us, “They do but they know what I want doing anyway.” One family member said, “They always speak to [family member] before they help [them].” People’s care plans confirmed the need for staff to gain consent and work alongside people when providing their care and daily records reflected this guidance was followed.

Following our assessment the provider gave assurances that systems were being implemented to ensure the service was working in line with the principles of the MCA.