WR Care Services

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.

This is the first assessment for this newly registered service. This key question has been rated 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.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing, and communication needs with them.

We were told, “I check [the care plan] when I start a shift or if there are updates.”

Partners told us, “They [staff] appear to understand the [person’s] needs when we try to address the best course of action.”

Records showed that the service reviewed care plans with people, their relatives, and professionals. This meant that staff were able to provide effective care that aligned with 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 but did not always use current evidence-based good practice and standards.

Recognised pressure-damage risk assessment tools were not used to identify people at risk of skin breakdown. This meant staff did not have documentation to advise who may be at risk of pressure damage and skin breakdown. However, care plans guided staff to apply prescribed barrier creams to protect people’s skin.

People’s care plans indicated if they required a modified diet, however, their daily records did not evidence that their food was being given with the required consistency. This meant the service could not be assured that people were receiving their meals in line with their needs, potentially putting them at risk of choking.

Staff told us they knew how to manage people’s nutritional and hydrational needs, feedback included, “We always give our clients enough time [during our calls] because some of [People] have different requirements such as slow chewing, or can’t be rushed due to [the risk of choking]”, and, “I always check preferences and any allergies or special diet.” This meant that people were safely supported to eat.

The provider worked well across teams and services to support people. They shared assessments of people’s needs when accessing different services.

Partners told us the service appropriately contact them for, “Moving and handling risk assessments, care package reviews, or equipment re-assessments. “They also told us, “[The service] will have done the necessary actions of calling [community medical services] when required.” Partners told us when people’s needs changed, they shared assessments and sought advice to “Ensure the person’s quality of life is maintained and promoted.”

People told us that staff contacted appropriate health services for them if they felt unwell and supported them to access community health services where necessary. Comments included “once the [community service] had discharged me they helped me to check it [condition],” and “I have COPD. They know how to help me.”

People’s care records contained detail from other services to support staff with care tasks. Changes were communicated via the electronic care system. This meant people remained central to a coordinated, multi‑agency approach to their care.

The provider routinely 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.

Care plans clearly outlined the areas where people were independent and where they required support with specific care tasks. People told us they were included in reviewing their health and wellbeing needs as possible. A person’s relative told us “[staff do well at] Take care of [person]. He is kept really clean, they have coped well with our family situation and our children being about.”

The servicesupported a person suffering from a mental health condition who could not maintain their quality of life. The registered manager told us, “A consistent team of carers focused on building trust” and provided “patience and respectful encouragement” to the individual to independently care for themselves and their home, access the community and reduce the formal care provision.

Another person was supported with regaining their skills, confidence and independence after a hospital stay. They required equipment to support their mobility and a care team for personal care tasks. The registered manager told us, “Staff provided supportive, rehabilitative care focused on maintaining independence and encouraging progress at the person’s pace.” The person was soon able to mobilise independently and carry out their own personal care without support.

The provider routinely monitored people’s care and treatment to help continuously improve it. They ensured that outcomes were positive and consistent. The provider undertook quality assurance through telephone monitoring, home visits, and surveys. This helped to manage risks and reduce the risk of poor outcomes to people.

Care plans included information about how people wanted to be supported to achieve their outcomes. For example, one person’s care plan stated, “If I am unable to walk, please use a hoist [to transfer].” Another care plan guided staff to put toothpaste on a person’s toothbrush so they could independently brush their teeth. People were encouraged to self-medicate where appropriate. Where people were living with dementia, staff were encouraged to prompt and support them to carry out care tasks themselves, rather than completing tasks on their behalf.

Staff knew how to monitor food and fluid intake. Care records evidenced people’s health and wellbeing was monitored during their care calls. Pre-assessment documents were included in people’s care files to ensure staff understood people wanted to achieve.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People and their relatives told us that staff always asked for consent before carrying out care tasks.

People had been consulted around their wishes. People’s care plans indicated where they could make decisions around their care and where they needed support to decide. Staff received training and demonstrated an understanding of the Mental Capacity Act 2005. They told us “It means we support people to make their own decisions where they can and always act in their best interests if they can’t. We respect choice and consent.” This meant people were able to stay in control of their care, their values and wishes understood, and their rights protected.

The provider carried out Mental Capacity Assessments to assess people’s capacity, however, did not always understand or document the process fully.

Care plans did not always document if people had a power of attorney. For example, out of four care plans we reviewed, one person’s care plan did not state who their power of attorney was. One person’s care plan was signed by someone who did not have the legal authority to consent to the person’s care.

We gave feedback to the provider, and they took action to remedy this.