Apex Prime Care Poole

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• 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 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s needs were assessed before using the service. The provider worked with other agencies and people and their relatives to gather information.

People and their relatives told us they had been involved in assessments of people’s needs and creation of their care plans. One relative said, “We have a care plan here.” Another relative told us, “Care planning involved us as family.”

People’s communication needs were assessed to maximise the effectiveness of their care and treatment. People’s care needs were routinely reviewed.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them.

People’s care plans contained information what was important to them, including about their goals, interests and hobbies.

When required people were supported with their nutritional needs. One person said, “Staff do toast and a cup of tea when they go.” Another person told us, “Carers do breakfast.”

The service worked with 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.

People and relatives confirmed they were involved in designing their care plan as well as reviewing it on regular basis.

A health and social care professional said, “From an engagement perspective, Apex attend forums and conferences as arranged, and I feel that the management team are good at proactively keeping us informed of any changes.”

The registered manager told us the service worked with others to ensure people’s safe return home after a hospital stay or an appointment.

The service supported people to live healthier lives and where possible, reduce their future needs for care and support.The service worked with external health and social care professionals.

Staff told us they knew people well and supported them to remain active.

People were supported to see healthcare professionals when required.The registered manager told us the service supported people to attend their healthcare appointments when requested.

The provider had a system in place to record their communications with health and social care professionals. This meant important information about people’s health was accurately captured and shared with relevant staff.

People and their relatives told us they did not have any concerns regarding staff monitoring people’s care.

One relative said, “[The person] has care. It is done with dignity and kindness. Their skin is in good condition.” Another relative told us, “If [the person] is unwell the staff contacts the service, and they ring me. If regular staff are there the response is quick, and the situation is well handled.”

A staff member said, “We maintain accurate records of all care provided including any incidents or changes in client's condition.”

However, some health and social care professionals told us the service did not always monitor people’s needs and level of care required. When people experienced a reduction in their needs, the length of care visits was not always reviewed to reduce the amount of time staff spent with people.This meant some people received more visits or longer visits than necessary, and some people were not assessed for more care when their needs had increased.

The Mental Capacity Act 2005 (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 Act 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.

Where necessary, people with legal authority or responsibility can make decisions within the requirements of the MCA. The provider did not have an overview of who could lawfully act on person’s behalf. In response to our feedback the service requested this information and was in the process of gathering it during the inspection.

The provider did not always make a clear assessment of a person’s capacity in relation to some decisions. The documentation in place was unclear and often contradictory. For example, we found 3 people’s capacity assessments stated they do not have capacity to make decisions. The assessments were not decision specific and incorrect as upon review of the documentation in place the registered manager confirmed people had capacity to make decisions on their behalf. This meant the provider could not be assured they were acting in the person’s best interests and in line with the MCA.

In response to our feedback the provider started to make the necessary changes to the relevant documentation and people’s care plans.

Some people told us they felt involved in decision making. One person said, “I’m involved in care planning.”

Staff told us they knew how to support people to make decisions in a person-centred way. A staff member said, “I consistently applied the principles of the MCA by presuming the client had capacity unless proven otherwise. I gave them time to process information and make their own decisions, using visual aids and simplified language when needed to support their understanding.”