FiNN Homecare Ltd - Head Office

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 changed to inadequate. This meant there were widespread and significant shortfalls in people’s care, support and outcomes.

The service was in breach of legal regulation in relation to people’s safe care and treatment, consent to care and governance.

This service scored 33 (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 failed to ensure people’s needs were assessed. Assessments did not consider the person’s health, care, wellbeing, and communication needs, to enable them to receive care or treatment that had the best possible outcomes.

We were not assured records contained adequate information or guidance for staff to meet people’s needs and mitigate known risks to keep them safe from harm, as there were no risk assessment, or guidance available. For example, there were no risk assessment or guidance in place for people who required support around repositioning, airway suction, falls, bed rails, skin integrity, mobility equipment, seizures, diabetes and catheter care.

People’s care plans were not regularly audited or reviewed. There was no evidence people had been involved in their care plans when they were written or when they were reviewed.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

We could not be assured people’s nutritional and hydration needs were being met in line with current standards and evidence-based guidance, as care plans did not contain adequate information.

One person’s care plan documented they required support with eating and with preparing a modified diet. Information around their support needs were conflicting, and there was no guidance in place. We spoke to staff about this person. Staff were unsure of the risk and felt the level of assistance required was dependant on the persons mood. This person was at risk of choking. Staff were unaware of this risk and confirmed they often left the person to eat independently.

Another person was supported with their nutritional needs through the use of a PEG. Information and supporting guidance in place was not clear in order to ensure they were safely supported with their nutritional needs.

The provider did not work always well across teams and services to support people.

Information within people’s care planning and assessments was not always accurate.

Information was shared with other services, however, there was limited evidence the service took action to keep people safe or contacted services in a timely manner.

Where professionals had carried out assessments of people’s needs, and taken action to keep the person safe, such as putting equipment in place.However, staff had no access to the information they needed to appropriately plan and deliver people’s care, treatment and support asthis guidance was not available within people’s care planning.

People’s documentation was not updated following hospital admissions or clinical appointments, which could impact when people moved between services, and the support required by other services.

Staff were positive about their working relationships with the provider.

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.

People’s health needs were not fully assessed, documented and reviewed which meant staff were not always able to support them to live healthier lives.

Where people had medical conditions, these were not included within their care plan and did not detail how these conditions affected people or what support they required.

People who used the service told us, “We have a good relationship. [Staff] come with me on appointments and is my driver too.”

The provider did not have a robust approach to monitoring the effectiveness of people’s care, treatment, and support to continuously improve it.

They did not ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Care plans referenced monitoring healthcare needs such as completing, blood pressure and oxygen saturation level observations. There was no guidance available regarding expected or baseline vital sign parameters or thresholds for escalation. Staff had not received training to ensure they understood or were competent to provide this care effectively.

The service was unable to continuously improve people’s care and treatment, as there were no systems in place to monitor people’s care and treatment, such as audits to identify issues.

People had not received effective reviews of their care.

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

The service was not always working in line with the principles of the Mental Capacity Act 2005. Where people lacked capacity to consent, decisions had not always been made in people’s best interests, and there was no documentation in place, such as mental capacity assessments or best interests’ decisions.

Care plans did not always contain information on how to gain people’s consent. One person was nonverbal. The care plan contained conflicting information about the persons understanding and there was limited information available on how they communicated, and how staff should communicate with the person to gain their consent.

Some staff we spoke with had good understanding of how they obtain consent. However, other staff were unsure. We heard, “I think [person] understands why they need to take their medication” and “I don’t know, [person is] a kind of person if you suggest something [person] will do it. I don’t actually know if [person] understands.”

Leaders had not undertaken training to ensure they understood the principles of the Mental Capacity Act and were therefore not able to effectively carry out capacity assessments.