Callquest For Care

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 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 operate effective processes to discuss people’s health, care, wellbeing and communication needs with them.

People’s needs were assessed when they started to receive support from the service. A person said, “[The registered manager] mentioned my risk assessment and care plan and speaks to [my partner].” However, following their initial risk assessment and care plans, people’s care had not always been regularly reviewed, and records had not always been updated when there had been changes in people’s needs. For example, a person told us they had previously been admitted to hospital and discharged on 2 occasions with a change in their needs. The person’s care records did not demonstrate that their needs had been reviewed, or their care records updated to highlight changes in their care and support needs.

Staff told us they received information about people’s needs. A staff member said, “They always give me the new guidelines about what the needs are,” but this was not consistently supported by documented assessments we reviewed.

Care records did not contain sufficient or up-to-date information to support safe and effective care. For example, 1 person’s care plan contained minimal personal information and lacked detailed guidance on how to meet needs such as nutrition, skin care and personal care preferences. Risk assessments were limited and did not clearly identify risks or actions to mitigate them, such as for catheter care, pressure sores or restricted fluid intake.

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

Although some needs for people were assessed and monitored, the provider had not utilised nationally recognised assessment tools such as MUST or Waterlow to support their assessment or care planning for people. Care records did not document how staff should monitor or respond to changes in health such as skin integrity and pressure care. People’s care records contained minimal details and did not contain person-centred information about what was important to people or how they liked their care delivered.

Staff had not received training to ensure they had the skills needed to deliver evidence-based care. This impacted on areas of care delivery such as medicines administration where we found medicines processes did not follow best practice. Both staff training and medicines processes are reported on under the Safe domain with further detail.

Despite these areas for improvement, some good practice was evidenced. Staff had identified changes in people’s conditions and contacted healthcare professionals for example when people experienced complications around their catheter care.

The provider worked well across teams and services to support people.

Staff described working with external professionals such as district nurses and GPs when people’s health needs changed. For example, staff contacted healthcare professionals when catheter issues arose or when signs of infection were identified.

People and relatives confirmed staff worked collaboratively with others. A relative said staff would raise concerns and contact them promptly. A person told us staff supported them during health changes and liaised with relevant professionals.

The provider supported people to maintain their health and wellbeing.

People were supported with nutrition and hydration, with staff ensuring meals and drinks were prepared and accessible. A staff member said, “I always leave [person] water… at 12 the water is finished so we top it up.”

Staff monitored people’s health and identified concerns such as skin issues or infections. They took appropriate action by contacting healthcare professionals when needed. For example, staff reported pressure sores and infections, which led to input from nurses. A relative said, “[The registered manager will ring and say I think [person] has an infection, [the registered manager] will pop into the doctors, she does out of her way which is helpful.”

However, these practices had not always been supported by formal monitoring systems or clear care planning, which limited consistency. The registered manager acknowledged the assessment feedback and began reviewing people’s care records to ensure better recording of people’s health monitoring and external input.

The provider informally 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.

Despite limited record keeping, people gave positive feedback about their care and outcomes. A person said, “I have nothing but praise for [staff member] … [staff member] always does what I ask,” and described improvements in their condition through consistent care and treatment.

Daily care notes showed that care needs were being met and consent was sought. Records demonstrated consistent delivery of personal care and monitoring of people’s wellbeing.

Formal auditing systems were limited. Audits of care records, medicines and call monitoring were either newly introduced or not fully embedded. The registered manager told us following the assessment they were going to introduce monthly auditing to ensure they had oversight of people’s care to monitor that this was being delivered as care planned and ensure people continued to receive positive outcomes.

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

The provider supported people to give consent to their care and treatment. Although staff had not received training on the Mental Capacity Act 2005, staff understood the importance of seeking consent before providing care. A staff member said, “I ask the client consent before anything can be done.” Staff supported people to make day-to-day choices, such as choosing clothing or meals. Staff described how they offered people choices in clear and simple ways to support understanding and decision making.

Care records and daily notes showed consent was regularly sought during care delivery. For example, records documented staff asking permission before starting tasks.

People confirmed they were involved in decisions about their care. A person described how staff discussed care with them and respected their choices, and relatives confirmed people remained in control of decisions where they had capacity.