Oaktree Homecare Services Limited

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 requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of legal regulation in relation to not always seeking people’s consent with aspects of the management of their care.

This service scored 50 (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 make sure people’s care and treatment was effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them in detail.

Risk assessments did not explore all the risks which people faced, with accompanying care plans to direct staff about how to meet people’s needs. The registered manager told us a person was at risk of choking, the information available to guide staff how to manage this need was insufficient and contradictory at times. The assessor had not directed the person and their relatives to professionals to help keep this person safe and ensure staff were doing everything to prevent a choking episode. Following our feedback, this advice from a professional was obtained and the service user’s care plan was updated. Another person could get aggressive towards staff but this was not explored to effectively support the person and staff when they delivered care and support to them.

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

A person’s needs were changing and despite being exposed to harm as a result of this, their needs were not re-assessed with new care plans made, and contact sought from health and social care professionals to help manage these needs.

When people first started to receive care, assessors did complete assessments when they considered people’s health and care needs and what people wanted them to do regarding this. However, opportunities were missed to explore these needs, especially as situations changed and staff got to know people.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

One person had raised concerns about potential theft in their home and the member of staff did not alert the registered manager about this. Another member of staff had been accused of damaging an item, they did not report this to the office or to the registered manager.

Some people’s relatives told us when their relatives received care from 2 members of staff often there would be delays in providing care as the second member of staff was late. These issues were not being raised with the office for the registered manager to resolve. Further work was needed by the provider to assure themselves everyone was working well together.

Staff said they received effective support by the office staff when issues arose, especially out of hours.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Staff and the registered manager were not always supporting the health needs of 3 people, even though the risks were high for these people and 1 person had experienced various incidents which staff had reported to the registered manager. No onward referrals were considered and sought to help staff and the registered manager to manage these health and wellbeing needs.

People and their relatives felt confident their regular staff would advise them or help them seek health input if needed. Staff had also recorded instances of doing this in people’s daily care notes.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent.

There was a lack of effective monitoring of people’s needs by the provider to ensure people were safe and received effective care and support. The provider and registered manager were not fully aware of the key needs and risks people faced which made it difficult for the registered manager to monitor these. For example, they were not aware of a person who had learning needs and another person who collected a lot items in their home.

Incidents were not always effectively reviewed to check the outcomes were appropriate and if actions were needed to improve the care individuals received.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The provider and registered manager did not seek people’s consent to take and retain photos of people when they had an injury or an accident. The provider’s incident form requested staff to do this, which routinely happened for 1 person, but no permission had been sought. The provider and registered manager had also not considered if this was an invasion of individual’s privacy.

One person was potentially being routinely restricted. Despite being aware of the actions being taken, both staff who visited this person and the registered manager’s understanding of the principles of the Mental Capacity Act of 2005 was not sufficient to identify a possible restriction and take the necessary actions of involving the person and health and social care professionals to help explore these issues.

The care assessors considered whether people had capacity or not, but there was not sufficient evidence recorded to support their findings. These assessments were not decision specific.

When care plans were reviewed and updated, people’s signature of consent was cut and pasted from their original care plan with no explanation they had consented to this new care plan.

When people’s relatives had legal powers to act in their relative’s best interests, which had been granted by the court of protection, there were no care plans to outline what these powers consisted of and what are the limitations of these powers, to help support staff and relatives to protect people’s rights.