St Elizabeth's 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 inadequate. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

At our last inspection the provider had failed to ensure people received support that gave choice and control to their lives. This was a breach of regulation 9 (person centred care) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Improvement had been made at this inspection and the provider was not in breach of regulation 9.

This service scored 75 (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.

Care plans were outcome-focused and regularly reviewed. People were encouraged to set personal goals and were supported to achieve them at their own pace. We saw examples of people having new experiences by visiting different places, attending health appointments and meeting new people and making new relationships.

People’s care plans were reviewed regularly. Relatives felt they were involved in discussions. A relative said, “We are happy with how settled [relative is] there is good communication, and we are involved in conversation about their care.”

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.

Care plans detailed how people required to be supported where they needed specific treatment for health and wellbeing. For example, where dieticians were involved, staff supported people in line with these recommendations and there were great outcomes for people which as a result had meant that people were able to have healthier lives. A relative said, “[Relative] is back to being my healthy, happy, handsome boy with a brilliant future ahead of him and I am secure in knowing whatever happens to me in the future [relative] will be safe and well cared for.”

Professionals felt that staff were knowledgeable about support people in line with best practice. A professional said, “The staff have a thorough understanding of the persons needs and support them to a high standard. They treat the person with respect, and they also consult them about what is happening despite their significant communication difficulties. They interpret the persons actions, and they focus in on activities they realise the person is enjoying. They also promote their independence and self-care skills, and they advocate on the persons behalf. The person is enjoying life and the opportunities being presented with to a level we did not expect.

The provider worked well across teams and services to support people. They made sure people were able to share what was important to them and only needed to tell their story once by sharing their assessment of needs when people moved between different services.

When speaking with staff they knew people well. Professionals also confirmed that when speaking with staff they were able to share what was important to the person.

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.

People were supported to access healthcare services and attend appointments. Staff worked closely with professionals such as GPs, social workers, and mental health teams to ensure continuity of care.

A professional said, “I had a recent situation where a resident had suspected dental problems. I contacted the staff members to request that a pain chart was completed for two weeks to document any suspected dental symptoms and returned to me via email. I did not have to send a reminder email- the document was returned to me completed on time.”

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.

People were supported to regularly review the support they received from the provider and other health agencies. They ensured that outcomes were positive, and people were involved in those discussions. For example, part of the support the service was where they would provide support in people’s homes where they attend college. They worked collaboratively with the college to ensure people’s educational needs were also filtered into their day to day lives.

People had health action plans in place and had support to review their health needs.

The provider focused on continuously improving the support they provided. For example, they introduced champions which focused on specific topics. These champions would be responsible in ensuring the service met these initiatives, encourage staff when they are doing something well, and positively challenging where improvements were required.

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

The service followed the principles of the Mental Capacity Act 2005. Staff supported people to make their own decisions and respected their right to take informed risks.

Staff ensured each decision made was done in way that meant people had all the information they needed in an accessible format. For example, this might have been through pictures and objects of reference. Where people were unable to communicate their own wishes, there were considerations to ensure appropriately skilled and knowledgeable people were involved in the best interest discussion to make sure the person’s voice was heard.