Care at Home Gloucester

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 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 75 (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.

There was a clear assessment process completed prior to people moving into their new home. This included an holistic assessment of their needs, preferences and aspirations, which ensured staff fully understood people’s individual support requirements.

Staff had received bespoke training around people’s specific health and social needs, such as long-term health conditions, life limiting conditions and behaviours of distress. Care plans and risk assessments were comprehensive, detailing individual need and the methods used for staff to meet those needs.

Every individual being supported had a person-centred communication care plan,which detailed how to communicate effectively to achieve good outcomes. Relatives told us they were happy with how their family member was enabled to communicate. Comments included, “They ask [my relative] things and [they] understand what they’re saying, not like the other place where [my relative] could’t communicate”, “[They will] signal by touching [their] mouth” and “[They are] not restricted in that [my relative] speaks and points a lot. [My relative is] generally good with communicating because [they will] take you by the hand and if it’s hurt, [my relative will] say and point to it.”

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 and current evidence-based good practice and standards.

The service supported people in line with legislation and current evidence based good practice guidance including CQC’s ‘Right support, right care, right culture’, the Resuscitation Council’s ReSPECT form and the International Dysphagia Diet Standardisation Initiative (IDDSI) food consistency guidance.

Systems were in place to review all incidents to ensure people had been supported using the principles of Positive Behaviour Support (PBS).

When monitoring was required, records were clearly documented, for example weight management and observation whilst eating due to an assessed choking risk.

The provider worked well across 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.

There was a strong focus on working collectively in the best interests of people. Staff and teams worked together with people to deliver coordinated,timely, consistent, person centred care and support.

Communication was reported to be good between the service and external partners. Advice was sought from specialists within the provider, such as Psychologists and Positive Behaviour Practitioners; as well as externally such as Speech and Language Therapy and Percutaneous Endoscopic Gastrostomy (PEG) specialists.

We observed staff working well as a team, supporting one another and showing dedication to ensuring the best possible care for those they supported.

The majority of staff told us they felt included, supported and valued. Comments included,“I have been here for 10 years and I would say we are in a better position than we have ever been”, “In my opinion I could not ask for a better manager. They have been very supportive and understanding” and “I feel well supported by my colleagues.”

The provider 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.

Staff meetings included discussion and guidance on healthy eating and dietary support for people being supported. These included, monitoring portion control, encouraging healthy choices and habits and meal planning.

People were supported to attend regular health checks with their GP or specialist healthcare professional. Comments from relatives included, “They try to monitor [my relative’s] eating as [they have] put on a bit of weight but [they] only like certain things and they’ve tried and do keep trying. [My relative] swims and walks and uses their bike, so [they] stay active as well”, “Yes, there’s always healthy food and it’s home-cooked” and “I’m really happy with this care and [they have] really improved weight-wise. And if [they have] an ear infection, they are so on the ball.”

Staff told us they were aware of encouraging and enabling people to live healthier lives. One staff member said, “If they eat too much chocolate we will redirect them to eat something that is better for them. They are given choices around food and there is a care plan around this. They will point at whatever they want. If we notice that they are eating the same thing over and over we encourage them to try to eat something else.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People’s care and support was monitored. New ideas were introduced to enhance people’s quality of life and life experience, such as new activities or work and education opportunities.

Most relatives told us examples of where improvements had been made which enhanced people’s health and well-being. One relative told us, “[My relative] does horse riding and [they] look as if [they are] having a better quality of life.” Another said, “Where [my relative] is now, [they] spend more time downstairs [communal space] compared to the home [they were] in before.”

Some relatives told us their family member needed more daily activity and to go out and about more.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

We observed staff giving people choices and offering support and help before assisting.

People were routinely offered choice and control over how they wanted to live their lives. Relatives we spoke with confirmed this. Comments included,“They ask [my relative] things and [they] understand” and “Yes, [staff ask consent] [they have] someone there supporting [my relative] with choice.”

Staff told us, “We give choices by showing people pictures” and “We follow policies and procedures and each individual care plan includes what people like and what they don't like. We ask for permission to do personal care, close the curtains and discuss things privately.”

The provider assessed people’s mental capacity. Where people lacked capacity, assessments were completed in relation to making decisions in people’s best interests. For example, relating to independent finances and tenancy obligations.

However, one professional told us,“The only criticism I have had recently was their understanding of the mental capacity act…I emailed and suggested there was a further training need there as they need to be aware that mental capacity is decision specific.” This was in reference to a specific health need and the mental capacity assessment covered only consent to care, support and accommodation.We shared these concerns with the provider who told us they would be raising awareness of this with staff in focused team meetings and supervisions.