Option Care 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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to good governance at the service.

This service scored 58 (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.

Whilst the provider used recognised tools to assess people’s needs, such as the Waterlow Pressure Area Risk Assessment to identify and manage people’s pressure ulcer risks, we found these had not always been used consistently. This meant that people’s needs were not always adequately assessed and planned for.

We received mixed feedback from people and their relatives about whether people had access to their care plan. Whilst some people told us there were care plans they could access, other people and relatives were unsure.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We received mixed feedback from people and their relatives about the capabilities of staff to deliver care. Some people and relatives highlighted concerns with the capabilities of some members of staff to meet their needs in relation to supporting with food and nutrition.

We reviewed care records of people who had a diagnosis of diabetes. The care records contained information on the type of diabetes the person was diagnosed with.Whilst the providers training record showed that not all staff had received training in this area, the provider told us that all staff working directly with people with diabetes had received training so that they could identify the signs and symptoms of hypoglycaemia or hyperglycaemia (sugar levels being too low or too high) and support people accordingly.

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.

We received mixed feedback from professionals about how well the provider communicated with them. One professional told us they thought the provider could improve by, “Being able to liaise with [their professional organisation] more effectively when things are difficult, if someone’s health is deteriorating or they have concerns …” In contrast, another professional said, “[The nominated individual] tends to be fairly easy to get hold of and he is happy to communicate.”

Staff gave positive feedback about communication within the organisation and said, “We have a team [communication] group. Members call and also communicate through that group. Communication is fast and effective. We also have staff meetings, so we talk.”

The provider was positive about their interactions with professionals and told us, “We routinely work in partnership with GPs, occupational therapists, Mental Health Teams, and social workers as part of our multidisciplinary approach to care delivery.”

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.

Whilst we received mixed feedback from professionals overall, we did receive some positive examples of how the provider had worked to promote people’s health and increase independence. One professional said, “They managed to care for a [person] who has been through multiple care providers for several years. I believe [the person] has now been transferred, but they were able to maintain [the] care package for her longer than anyone else.”

Care records contained details of what people needed support with and what they could do independently. Staff told us they supported people with their health and wellbeing. One staff member said, I seek clarification on symptoms, be empathic and be a good listener to understand a person’s health care concerns. I escalate to my manager if I notice signs of deterioration.”

We saw an example of how staff had liaised with a person’s GP practice to promote their health and wellbeing.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Systems and processes were not consistently used to monitor outcomes for people. For one person who experienced behaviours of distress, we saw systems in place to guide staff. However, for other people we did not see any systems in place to monitor and improve outcomes for the support being provided.

The service did not always understand the expectations people had about the care they received and what positive outcomes looked like for them. For example, one person told us, “I have been using them for [several] years. I do feel safe in the evening. Some in the morning I do and some I don’t. I think it’s their experience they don’t know what to do [to support my needs].” A relative told us, “[My relative] needs support with [with specific needs] but they are not currently doing it as they haven’t built up trust.”

Whilst there were processes in place, and staff told us they knew how to escalate concerns, we received mixed feedback from professionals about how effectively this was working in practice.

We saw the provider had raised concerns with staff relating to the importance of escalating where there were changes to people’s care and treatment. We also saw the provider had taken some action to address this. However, more time was needed for this to be fully embedded to ensure there was a robust approach to monitoring the effectiveness of people’s care, treatment and support, with action is taken to continuously improve it.

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

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make decisions, any made on their behalf must be in their best interests and as least restrictive as possible.People, where possible, signed to confirm consent to their care plan. Staff demonstrated an understanding of capacity and consent. One staff member said, “I always assume capacity first, support people’s choices and act in best interest of individuals lacking mental capacity. The Mental Capacity Act is a law which helps to support people to make their decisions.”