16 Westmoreland Road Also known as Quality of Life Homecare 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 good. At this assessment the rating has remained good.

This service scored 63 (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 and staff worked to make sure people’s care was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider explained that needs assessments informed people’s care plans. They had recently introduced a number of improvements to people’s care and risk management planning to ensure people’s needs were more fully assessed and reviewed with them. These now included more person-centred information about people’s health, care, wellbeing, and communication needs. People and relatives told us they were involved in planning and reviewing people’s care needs when they wanted to be. Staff told us they were involved. A care worker said, “I get to know the person very well and so I can help provide an understanding of the needs and risks they are facing.”Staff said they found the information helpful and commented, “If I have any doubts I just ring my line manager” and “If I find the risks or care needs listed are not correct, I will say so but I’ve not had to do it.”

The provider planned and delivered people’s care with them. Recent improvements to the format of care plans meant these now included more information about people’s strengths and abilities and what was important to them. For example, we saw a person’s updated care plan set out their interests and likes as well as support they required for their physical and mental wellbeing. Other people’s care plans had been reviewed to better detail the support they needed when living with dementia, or experienced confusion or neurological issues. Staff we spoke with demonstrated an understanding of people’s preferences.Staff supported people to eat and drink when this was part of their planned care arrangements.Some care notes showed what food and fluids staff had supported people to take, but some did not always provide sufficient detail. The provider took action to address this after we raised it with them. The provider shared information with people and staff on keeping hydrated during hot weather.

The provider worked with other services to support people.

We saw evidence, for example, of the service requesting urgent re-assessments and replacements when a person’s walking equipment needed repair and meant they couldn’t access their community. Staff we spoke with understood about working with other health and social care professionals to meet people’s needs. A staff member explained how when they noticed a person’s mobility was declining they had reported this to their managers who arranged for a supervisor to re-assess the person’s needs. This information was shared with the local commissioning authority so they could review and increase the person’s level of care.

The provider supported people to manage their health and wellbeing but this was not always done in a way so people could maximise their independence, choice and control.

People’s care plans set out their health needs and how a health condition may affect their daily living. However, care plans did not always consider people’s oral health needs, such as if they needed support to brush their teeth. A person with a learning disability’s care plan was not clear about supporting them to attend their annual health check with a GP. Also, while their care plan set out their communication support needs, the person did not have a hospital passport. This is used in the event of a person having to go to hospital to ensure healthcare professionals have relevant information on the person’s needs, likes and preferences, especially when they cannot always speak for themselves.

Staff worked with healthcare services to support people to meet their health needs. Staff told us, “We work well with other professionals like the GP and Nurses.” Service records also indicated this took place regularly. Staff said they reported people’s health concerns to their manager who responded promptly and engaged healthcare professionals. A relative told us they appreciated that staff understood their family member’s health condition.

The provider monitored people’s care and support, but the systems in place for this had not always been effective at providing assurance care always met people’s needs and they experienced good outcomes.

It was not always clear if the provider reviewed people’s care plans when there had been a change in their needs. Staff made records of their care visits but some of these did not always clearly account for the care provided or how the person was at the time. This meant the provider could not always be assured people’s care was meeting their needs. We saw the provider had recently introduced improvements to people’s care plans so they more accurately reflected people’s expectations of their care. The provider had also taken action to improve daily care recording practices after we raised it with them.

Generally, people and relatives we spoke with were happy with their care and said it met their needs. A relative said, “We are happy with the service and [the person] is getting better.” Some relatives told us the care service had led to an improved quality of living for both them and their family member. The provider was in the process of seeking the views of people and relatives about their care using satisfaction surveys at the time of our inspection.

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

Some people’s care records noted when they lacked capacity to make decisions about their care and a relative or partner made these decisions on their behalf. However, the provider did not always ensure they had evidence the person had the correct legal authority to make such decisions for someone else. There were mental capacity assessments in place where a person lacked capacity, but some of these required further detail to demonstrate how the conclusions had been reached. The provider said they would review care plans to address this.

Staff had received mental capacity awareness training. Some staff we spoke with were not clear what the Mental Capacity Act 2005 was, but they could explain how they sought people’s consent to their care and respected their choices. Daily care records showed when people’s decisions were respected when staff were providing their care, such as when and if they wanted to wash or what they wanted to eat. Feedback from people and relatives also indicated staff supported people to make decisions while respecting their choices. For example, a relative spoke about how a person living with dementia needed encouragement to choose to have a shower.