Highgate Home Care Also known as Willerby Office

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 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.

Initial assessments were completed, and there was evidence of involvement from occupational therapists, speech and language therapists (SALT) and district nurses where required. However, several care plans lacked essential clinical and communication information. In some cases, SALT advice, diabetes management guidance and mental health information were recorded elsewhere but not reflected in the main care plan. This provided limited assurance that staff had access to complete information at the point of care. The registered manager took immediate action to address these concerns.

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, information within care plans was not always consistent or aligned with current evidence‑based guidance. For example, about what food people were able to eat.

There were examples of good practice, including the use of appropriate equipment and involvement from occupational therapists to support mobility and rehabilitation. However, gaps in care planning meant staff could not always easily access evidence‑based instructions, such as swallowing guidance or diabetes management, which reduced assurance that care was consistently delivered in line with best practice.

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.

Staff described effective teamwork, regular management and care manager meetings, and access to on‑call support.There was evidence of joint working with occupational therapists, district nurses and hospital teams to review care packages, arrange equipment and adjust support as people’s needs changed. Managers shared information through meetings and encouraged staff to raise concerns so decisions could be made collectively, helping ensure people received coordinated care.

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 encouraged mobility, nutrition and rehabilitation, and worked with health professionals when needed. Care records showed staff supported people to stay active and socially connected, including attending community and faith activities that were important to them. Staff described supporting people to remain independent in their own homes for as long as possible.

The provider routinely monitored people’s care and treatment 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.

Records included evidence of reviews, professional feedback and escalation of concerns about changes in people’s health or wellbeing. Systems to monitor outcomes were in place and developing. Information such as decisions about whether people wanted to be resuscitated in the event of a medical emergency (DNACPR) was recorded where applicable, and staff described how they raised concerns so care packages could be reviewed and adjusted.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Consent forms were in use, but we found instances where relatives had signed on behalf of people without evidence the person lacked the ability to make the decision, or appropriate authority. Records did not consistently show people’s mental capacity to make decisions about their care and treatment. Where people lacked capacity, lasting power of attorney documentation was not always available, and senior staff could not clearly explain where capacity assessments and related information were stored within the electronic system. This reduced assurance that decisions were always made in line with people’s rights and best interests. The registered manager confirmed actions had been taken following the inspection to address these concerns.