Michael Batt Foundation Domiciliary 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

The processes in place to support people to mitigate the risks associated with becoming agitated and displaying behaviours which may challenge others, included strategies and techniques. People experienced support which maximised their choice and control and staff supported them in the least restrictive way possible and in their best interests. Although improvements have been made with regards to the effectiveness of the service, systems and processes were still being fully embedded. Therefore, the provider still needs to demonstrate it can fully embed and sustain these improvements.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

One person was able to inform us through their personal communication preference that the registered manager and staff had assessed their care needs. A relative told us, “Recording of seizures has gone online which makes things simpler and there is no paperwork to go astray”.

The deputy manager described how the service assessed people’s needs and developed electronic person centred care plans and risk assessments. These were reviewed on a regular basis with the involvement of people, relatives, and staff, and audited monthly in conjunction with the nominated individual as part of the providers governance processes.

At our last inspection we found the provider had failed to ensure people received care and support in line with their needs and preferences. At this assessment we found the service had improved. The service had introduced a new electronic care planning system. Whilst we saw the majority of peoples information had been updated and transferred to the new system, we recognised, along with the provider, that the system needed time to be fully embedded and improvements sustained.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

Feedback from people was positive. One person indicated how the staff team worked with healthcare professionals to ensure people had continuity of care. A relative we spoke with told us, “As far as his medical issues go, pretty much all the facilities that he needs are well organised and in hand”. Since our last inspection the new registered manager had developed systems to capture people experiences. However, these systems were still in their infancy and needed to be fully embedded.

Staff and the provider understood the importance of working well together whilst ensuring people received continuity of care when accessing services within the community. Comments included, “We work well (with partner agencies). (Person) has visits from (healthcare professional) weekly any information is passed on (to the healthcare professional, who shares this with a specialist consultant). Anything that needs attention for (person) is put in place”, “If we need any support from (healthcare professionals), we can go to the management, and they will contact the relevant agencies” and “We work effectively across teams and services to support people. We make sure they only need to tell their story once by sharing their assessment of needs when they move between different services”.

We spoke with a healthcare professional who described how they worked in partnership with the service. They told us, “They have been able to contact us for support at times when the client’s needs changes or worsens”.

The registered manager and provider had introduced new systems to capture and record how staff and services were working effectively together. For example, how one person’s seizure care plans and monitoring charts were being captured, recorded and used to support referrals and ongoing reviews with a specialist epilepsy team.

Feedback from people was positive. One person indicated how the staff team had supported them to a recent healthcare appointment.

The registered manager was able to describe people’s individual needs and what this meant for supporting people to access their healthcare appointments safely and in a safe and timely manner. They described to us the systems and processes in place to mitigate the risks associated with people becoming agitated and displaying behaviours which may challenge others.

The processes in place to support staff to mitigate the risks associated with people becoming agitated and displaying behaviours which may challenge others, included strategies and techniques to support a person from becoming anxious and upset. The provider had a system that captured when people were due to have appointments with G.P’s and opticians and alerted staff when these appointments were due, so they could ensure people were supported effectively.

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.

People experienced support which maximised the choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. One person had fluctuating capacity to consent to parts of their care. Fluctuating capacity is when a person's ability to make a specific decision changes over time. Where the service supported the person to make decisions about different aspects of their care during times when they lacked capacity, there were mental capacity assessments to show these decisions had been made with the person and in their person's best interests and with appropriate consent.

The registered manager and provider fully understood their responsibilities to ensure people received support that was consented. The registered manager and operations manager described the systems they had put in place since the last inspection. This included an audit of restrictive practices to ensure they were in the persons best interests and had the appropriate consent. A staff member we spoke with told us, “We always assume someone has the capacity to consent until we identify that they don’t”.

At our last inspection we found the provider had failed to gain appropriate consent when delivering care and support. At this assessment we found the service had improved. The providers policies and systems supported people to have maximum choice and control of their lives. This supported staff to deliver support in the least restrictive way possible and in people’s best interests.