Northumberland Mid & North Domiciliary Care Agency

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 outstanding. At this assessment the rating has remained outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.
 

This service scored 88 (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.
The management team completed assessments with people before they moved to the service. Care plans were robust, person-centred and reflected people’s assessed needs. Records were updated when people’s needs or preferences changed. People and their relatives said staff regularly discussed their care with them. Staff said they were encouraged to take time to read and understand care plans.
 

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.
People and, where appropriate, their relatives or advocates were involved in planning their care. Care plans and risk assessments were exceptionally person-centred. For example, multiple people had risk assessments in place for learning new skills and developing skills, each one differed depending on people’s level of confidence and ability.
Staff were given time to understand people’s care plans, a staff member said, “All members of staff are encouraged to take time out to read care plans, new staff shadow experienced staff for many weeks to ensure they are comfortable. When plans change all staff must read and sign any changes.”
Health and social care professionals said all staff knew people exceptionally well and followed the guidance they provided.
 

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.
Staff worked exceedingly well as a team; they constantly supported each other and found it very easy to speak to all members of the management team. Staff told us this strong team enabled them to provide exceptional care to people. A staff member said, “We have a very good staff team, with a lot of strong individuals, every staff member brings something else to the table.”
Visiting professionals praised staff for how well they worked with them, with one saying, “Staff have been confident in working with myself as a visiting professional; they have readily asked questions and shared their perspectives and observations and have advocated for the person in terms of their known preferences, needs and independence. They have been very open to considering other options and have actively sought feedback on their support. They have been keen to share how they are meeting the person’s needs – and to check that they are doing as much as possible.” For example, staff worked with housing providers and the local authority to advocate for people, helping them improve their homes or living circumstances.
People knew staff were in touch with healthcare professionals on their behalf. One person explained staff supported him with appointments and helped listen to the information he was given in case he forgot.
 

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.
People were empowered and encouraged to take an active role in improving their health and wellbeing, with staff providing highly personalised support that reflected individual goals, preferences and strengths. Staff went beyond arranging access to healthcare services and worked creatively with people to achieve positive and sustainable health outcomes.
For example, one person had identified weight loss as a personal goal. Staff supported them to attend a community weight management group and worked with them to develop healthier dietary choices. The person was proud of the progress they had achieved and the weight they had lost, demonstrating the positive impact of the support provided. They were invited to speak at their weightloss group to inspire other members.
Another person had been advised to increase their physical activity to improve their mobility. Recognising that walking was not an activity they enjoyed, staff developed an individualised approach to motivate and encourage them, introducing incentives and positive encouragement to help them engage. This resulted in the person participating more regularly in walks and experiencing improvements in their health and wellbeing. One person described the service's proactive approach to health promotion, saying, “There is a health workshop we go to.”
Staff demonstrated a strong understanding of people's individual health needs and adapted their support accordingly. People were supported to maintain good oral health, with staff using personalised strategies to encourage effective oral hygiene where people were reluctant to engage. For example, staff had developed successful approaches to support one person with tooth brushing, helping them maintain their oral health in a way that respected their preferences. Staff also ensured people accessed healthcare screening programmes and appointments when required, helping to promote early intervention and positive health outcomes. This proactive and person-centred approach enabled people to achieve measurable improvements in their health while maintaining choice, control and independence.
 

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.
People experienced positive outcomes because their progress, wellbeing and aspirations were continuously monitored and reviewed. Staff knew people extremely well and recognised changes in their needs quickly, enabling support to be adapted promptly and effectively. There was a strong focus on helping people achieve outcomes that were meaningful to them, with positive risk-taking actively encouraged to enhance independence, wellbeing and quality of life.
The impact of this approach was evident in the significant improvements people had achieved. For example, one person experienced a deterioration in their health which meant they were no longer able to take food orally. Eating had always been an important part of their life and losing the ability to enjoy food had a profound impact on their wellbeing. Staff worked tirelessly alongside healthcare professionals and the person to safely reintroduce oral food intake. Through perseverance, skilled support and a shared commitment to achieving the person's goal, they were able to progress from being unable to eat to enjoying small meals and one of their favourite treats, chocolate. A healthcare professional praised the team's commitment and said, “Although [person] has a significant dysphagia he has been able to move from being non-oral to having all of his nutrition needs met by eating – a much-loved activity for him. The care team have never faltered in implementing the precautions needed and this has enabled a safe and steady increase in oral intake and pleasure for [person].” This outcome had a significant impact on the person's wellbeing, enabling them to regain an activity that brought them comfort, enjoyment and a sense of normality.
People were empowered to identify and work towards their own goals, ensuring support was driven by what mattered most to them. Goals included developing skills to manage finances, accessing the community more independently and safely, and increasing or maintaining independence in everyday life. Staff regularly reviewed progress with people, celebrating achievements and adapting plans where needed to help them continue to succeed. This highly personalised approach ensured people experienced sustained progress and meaningful improvements in outcomes, while retaining choice, control and independence in their lives.
 

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.
Staff demonstrated a clear understanding of the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular 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 particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
Appropriate mental capacity assessments and best interests decisions were in place to ensure people were safe and cared for in their best interests. People were supported in line with court of protection orders.