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. At the last inspection this key question was rated as Requires Improvement. At this inspection this key question has now improved to Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. Assessing people’s needs and choices; delivering care in line with standards, guidance and the law
A&M Homecare CQC report findings 2020
Effective with needs
● People’s needs were assessed prior to them using the service to ensure their needs and preferences could be met.
● Both people, and their relatives, where appropriate, were involved in the assessment process to ensure this fully recognised people’s diverse needs and choices.
● Where people had complex medical conditions, the registered manager liaised with other healthcare professionals to develop the person’s care plan and ensure the care provided was based on best practice and advice. Staff support: induction, training, skills and experience
EFFECTIVELY TRAINED
● People told us they felt staff knew what they were doing and were suitably trained to meet their needs. One person said, “They know what they are doing. They seem well trained and if anything is tricky [registered manager], puts them right.” A relative told us the registered manager had worked with new staff who as a result of their training had become “fantastic”. They stated the staff had “really learnt” and were “so much better.”
● Staff received an induction when they started working for the service which included working alongside more experienced staff until they felt confident to work independently.
● Staff had completed essential training such as moving and handling people and basic food hygiene. Refresher training was planned on an annual basis for staff to update their skills and knowledge.
● All staff had started training to achieve the Care Certificate and were at various stages of completing this. The registered manager had identified the need to organise group training sessions to support staff in completing the units required in a more timely way. The Care Certificate is an agreed set of standards that sets out the knowledge, skills and behaviours expected of staff in the health and social care sector.
● Staff received regular supervision meetings with the registered manager to ensure any training needs were identified and acted upon. Supporting people to eat and drink enough to maintain a balanced diet
Effective Nutrition
● People told us care staff supported them with food and drinks during care calls as required. One person told us, “They serve meals and they are nicely done and simple stuff…They do me just enough and it’s served nicely, and they tidy up after.”
● A relative told us, “Yes, the carers do [Name’s] food, they (person) enjoy the meals which we prepare for them and they are warmed up, or they (care staff) will do them a breakfast or a quick hot meal.”
● People’s nutritional needs were assessed and recorded in care plans to ensure care staff knew how to Good 10 A&M Home Care Services Limited Inspection report 01 April 2020 support people with this. For example, one person received their nutrition through a feeding tube and there were detailed records about this. Staff knew how to manage this and how to clean the tube to prevent the risk of any blockages. Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier lives, access healthcare services and support
Effective Healthcare
● People told us they were supported to access healthcare support when needed. Some people had relatives who did this for them, otherwise staff assisted them when required. One person told us, “They (staff) alert me if I need a doctor and I will call one or they call them for me. That’s nice as I can’t see things easily.”
● A relative told us, “They let me know straight away if something needs attention. If [Name] needs things they check with me on it all and they get the doctor out if they are needed.”
● When staff had concerns about people’s health or wellbeing, they reported this to the registered manager and access to medical care was organised as required.
● People’s mouth care needs were considered as part of care planning in case dental care support was required. Ensuring consent to care and treatment in line with law and guidance 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 Act 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.
● At the time of our inspection, every person receiving support had capacity to make their own every day decisions about their support needs. People told us staff checked it was ok with people before providing them with care and support.
● Staff had received training on the MCA and understood the importance of ensuring people’s rights were protected.
● People’s mental capacity was considered during the assessment of their needs to identify if they would need support with specific decisions linked to their care. The registered manager told us some people had relatives who had Lasting Power of Attorney (LPA) to enable them to lawfully make decisions on people’s behalf.