Assist Care Group - Surrey

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 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.

People were fully involved in discussing and reviewing their care plans which covered their health and care needs. Care plans reflected people’s goals and the outcomes they wanted to achieve. People told us staff had a good understanding of their care needs. One relative said, “[Staff and management] are very good, and I always get an answer, they respond quickly and they know [my relatives] situation."

Staff had a good understanding of people’s needs and completed training relevant to people's individual needs and areas of health, safety and first aid. Staff kept clear, comprehensive care records to support reviews and evidence of any action taken in response to changes in people’s needs. 

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 were personalised and guided staff to work in accordance with best practice guidance. Care plans clearly detailed when staff needed to escalate concerns to healthcare professionals when people’s needs changed. Where advice and guidance had been shared by professionals, this had been recorded in people’s care records for staff to follow.

The management team ensured they remained up to date with best practice and what local services were available. For example, they attended and were involved in regular homecare provider forums to ensure their knowledge of local and national best practice remained current.

Records evidenced consistent, responsive care which adapted to people’s changing needs, ensuring their safety. Wellbeing and independence was promoted in people’s care records. This proactive, co-ordinated personalised approach ensured people consistently achieved positive outcomes. For example, where people used lifeline alarms, there was clear documentation so that staff could check people were wearing these in their absence to promote their confidence and independence as far as practically possible.

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 had access to the information they needed to assess, plan and deliver care effectively. Digital care records were clear and up to date, helping ensure timely continuity of care. Information was shared appropriately between teams and services, including when needs changed or when people were referred to other professionals. A staff member told us, “When a person's condition or care requirements change, information should be communicated accurately and quickly. Responses from outside services can occasionally be delayed, especially when professionals are handling heavy workloads. When this occurs, we appropriately follow up and raise concerns when needed.”

Staff made referrals in a timely way to help ensure people received the right support. Effective communication with external professionals and relatives was evidenced through case studies which supported oversight and coordination of care. A staff member said, “Communication with external professionals is an important part of maintaining continuity of care. We work with GPs, district nurses, social workers, occupational therapists, and other professionals where appropriate.”

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 monitored people’s physical and emotional wellbeing during visits and supported them with personal care, oral care, nutrition, hydration, mobility, medicines and access to health appointments. Care records showed staff were clearly signposted to escalate changes such as pain, reduced mobility, poor appetite, confusion and signs of infection.

The service identified risks to people’s health and wellbeing and prioritised support to prevent deterioration as much as possible. For example, we reviewed the record for a person who required ongoing support for substance misuse. We saw how staff had been given clear guidance to manage their dependency and minimise the potential for emergency admissions.

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.

Regular monitoring and checks were carried out and analysed, helping to identify issues, learn lessons, and develop action plans to improve the quality and safety of the service people received.

It was clear from the feedback we received the managers and staff recognised the importance of learning lessons and continuous improvement to ensure they maintained high-quality, person-centred and safe care for people. This included learning when things had gone wrong and reflective learning to continually develop.

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.

Staff worked in accordance with an up-to-date customer consent policy which clearly set out that any person who might not have the mental capacity to give valid informed consent about any care and treatment proposed, was properly assessed in line with the requirements of the MCA.