Independent People Homecare

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• 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

We reviewed 4 quality statements under this key question: assessing needs, delivering evidence-based care and treatment, supporting people to live healthier lives and consent to care and treatment. Prior to receiving care people were assessed to ensure the service could meet their needs. People’s needs were assessed, and their choices recorded. Care plans were holistic taking into consideration people’s physical, social and cultural needs. Daily notes demonstrated the care provided reflected people’s expressed wishes. People and those close to them were involved in the planning and deciding how they received their care, Systems were in place to ensure care plans were regularly reviewed. The service was proactive in its response to concerns or complaints and people and relatives were given the opportunity to feedback their experiences.

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.

People told us they had been involved in the assessment and review of their care needs. One relative told us, “They understand [persons] needs very well and there are no problems. The level of professionalism is incredible.”

Care plans included assessments which identified potential risks and measures for staff to minimise them. The care manager told us, “We created our own pre care assessments to ensure we created the questions we needed answering. For example, customers wellbeing, their chosen activities. If supporting someone with diabetes, training for the live in carer needs to be in place, medicines, and diet information to ensure no adverse reactions. This information we obtain form the person, relatives, and professionals. The carers are given access to all documents.”

Processes were in place to identify people’s needs and develop individualised care plans which reflected them as a whole. The senior management team met with people and their representatives to discuss their needs and wishes. People’s care plans were reviewed regularly and updated when required.

People and relatives told us staff were proactive in encouraging them to eat and drink to maintain a balanced diet of their choice. Comments included, “One particular carer is keen on reporting back to me when [person] is not eating properly. They are on a specialised diet, and it has been an uphill battle. The carer has been encouraging and keeping a watchful eye. They are all excellent,” and “They [staff] will take hours to feed [person], they are so lovely with them. There is a comfort in knowing that they love [person], and they do not get anything in return.”

Staff understood the importance of supporting people with their meals, including those with specific dietary needs. They supported people at mealtimes and encouraged them to remain hydrated during the day. Staff were aware of people’s dietary needs and the level of support they required. A member of staff told us, “Some people have their meals delivered to them, these can also be for people who have a specific dietary requirement like a pureed meal if a person has swallowing difficulties.”

Processes were in place to assess people’s nutritional and hydration needs. People's care plans detailed the support they required to eat and drink safely and their preferences in snacks, meals and drinks.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

Care plans contained information on specialist advice to ensure staff supported people to maximise their health and well-being. People were involved in regular reviews with health professionals as required. Relatives were kept updated on their family members health.

The service was proactive in developing and maintaining relationships with health and social care professionals to ensure people received effective care and support. Staff referred to a variety of services and worked closely with health and social care professionals for the benefit of people in the service. Care plans included information about people’s healthcare needs and guidance about how best to support them. A member of staff told us, “I read [person’s] care plan and engage with them on a one-to-one basis. I have been provided with training specific to [person’s] condition.” The person has the support of a large multi-disciplinary team for example, occupational therapy, physiotherapy, Neuropsychology, and Independent People Homecare agency.”

Processes were in place to ensure staff kept health care professionals informed about people's progress and any changes in their wellbeing. Visiting health care professionals recorded any updated guidance or changes in a person’s condition in their care plans. Care plans contained information on specialist advice to ensure staff supported people to maximise their health and well-being.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

Staff consulted people about their care and supported them to make day to day decisions. People’s views and preferences were incorporated into person centred care plans. Comments included, “The carers know my likes and dislikes and I make my own choices and decisions,” and “They [staff] are always very mindful and ask for consent.”

Staff had received MCA training and understood the principles of the MCA. They gave examples of how they applied the principles when supporting people and understood their responsibility to report if they had any concerns a person may be lacking capacity. One member of staff told us, “The person I provide support to is deemed to have capacity and can make decisions. I offer choice and informed choices, depending on their ability, I encourage independence of chores which the person can manage and is capable of.”

Where appropriate, the provider had assessed people’s capacity to make decisions about their care and treatment. Consents had been obtained from either the person or with involvement from their representative lawfully acting on their behalf as the decision maker. People’s care plans included information around people’s capacity and how people understood and communicated choices.