Prime Care Domiciliary Essex

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. We assessed a total of 6 quality statements from this key question. This key question has been rated require improvement. This meant the effectiveness of people's care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives told us they were not always involved in the planning if their care and support needs. We found limited evidence to demonstrate people using the service were involved in the assessment of their needs or developing their care plan and risk assessments. Although people told us that staff knew them well, a relative told us, “The staff all seem to know what to do but I haven’t seen a care plan.”

The registered manager told us they carried out a full assessment of people’s needs before they came to the service to ensure their needs could be met. This involved meeting people and getting feedback from health professionals involved in the person’s care. However, we found people’s care plans and risk assessments were not up to date or completed accurately.

People's care plans and risk assessments were not always personalised, and support was not always in line with people's care plan. Records we looked at failed to demonstrate people’s needs were being regularly reviewed through assessment to ensure their support plans continued to reflect their needs.

A person told us, “We do the meals, but the staff are very good at making sure (relative) has a drink before they go and seeing if they need anything else. It’s all been very professional.” Another person told us, “They do [relative’s] meals, they do breakfast and lunchtime, [relative] just likes fruit and a yoghurt, and they peel the fruit, and, in the evening, they just heat up what I have left or a ready meal, it has to be really mushy for [relative] and they know exactly what to do.”

Staff supported people to have the meals of their choice and supported them to have enough drinks during the day and this information was recorded in people’s daily notes. A staff member told us, “I always talk to people and offer choice and overtime we get to know what their likes and dislikes are.”

People's care plans and risk assessments were not always personalised, and support was not always in line with people's care plan. Records we looked at failed to demonstrate people’s needs were being regularly reviewed through assessment to ensure their support plans continued to reflect their needs. The registered manager did not complete care plan audits. This meant people’ care plans were not updated, and staff did not have accurate and up to date information.

Most people were happy with the staff team supporting them. However, a relative told us, “Whenever I have tried to ring the office, no one ever answers, and they don’t call you back.”

Hospital staff sent information about people’s needs that staff had access to so they could support people safely. The registered manager told us they had developed good links with health professionals. A member of staff told us, “The manager updates the care plan when we have any new information, so we know exactly what we need to do.” However, we found care plans and risk assessments were not always updated or accurate.

We received positive feedback from a health professional. They told us, “There is excellent communication between us and Prime Care, and we work very well together. The management are approachable.” However, people’s care plans did not contain information about involvement with other professionals and how staff worked in partnership with others to help ensure people received personalised care and support.

The management team conducted staff meetings and cascaded messages regularly with staff, so they were provided with current information to work together to support people. However, this information was not always recorded, accurate or up to date.

People and relatives told us they were supported to access healthcare professionals to prevent deterioration and promote their independence.

Staff had completed additional training so that they could identify when people needed further support. Staff were able to support people attend appointments and could raise any health concerns for further review where needed. A member of staff told us, “I have all the training I need to be able to support people safely.” However, the staff training matrix did not include dates the training was completed. This meant we cannot be assured staff were trained and skilled in supporting people safely with the relevant training required. Following the assessment, the operations manager sent an updated training matrix which included dates of completed staff training.

People's care plans and risk assessments were not always personalised, and support was not always in line with people's care plan guidance. There was a lack of clear guidance and key information in care plans to enable staff to deliver the right and consistent support people needed when distressed. Improvements were required to ensure completed care plans and risk assessments were person centred and included how risks to people were to be mitigated and reduced. Some information was generic and not personalised to the individual people using the service.

People told us staff regularly met with them to review their care and support needs. However, people and relatives told us they had not received any communication from the management team once the care package had commenced.

The operations manager told us they had systems in place to monitor care outcomes and used this information to develop the service. For example, they monitored call times, and the number of carers involved in people’s care. However, this information was not recorded or analysed to look for themes and trends or to see where improvements were needed. The operations manager told us they made regular calls to people and relatives to obtain feedback. However, everyone we spoke to confirmed that had not received any calls.

The provider’s processes for monitoring and improving people’s outcomes was not always robust. People who were required oxygen did not have care plans or risk assessments in place. Risks associated with their oxygen therapy were not considered or documented. People who required support with their diabetes did not have a care plan or risk assessment in place. This meant that staff were not support people in the management of diabetes putting the person at risk of developing hyperglycemia. We recommend the manager develops tools that monitors people’s outcomes to measure if they are positive or need further improvements.

Consent to care and treatment was sought in line with legislation and guidance. People we spoke with told us they were able to make some informed choices.

Staff had received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff understood the need to gain consent from people to support them with their care needs and in making decisions. Staff told us, “I have recently completed my training, and I understand the importance of gaining consent from the people I support.”

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. We found staff practice reflected the principles of the MCA. People were encouraged to make their own decisions, while still minimising risk. Staff understood their roles and responsibilities in relation to the MCA 2005 framework.