Radfield Home Care Chippenham & North Wiltshire

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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 6 quality statements for this key question.

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 and relatives shared positive feedback with us regarding assessments carried out by management. One person said, “They [management] came out and did a house visit. The [nominated individual] came out and they went through everything.” One relative told us, “They [management] came, and they did a thorough assessment of [person’s] care at the time.”

The registered manager had a clear process for setting up new packages of care. They told us they initially captured some information from people on the telephone and then visited the person to talk about the organisation.

People’s needs were assessed prior to care packages being agreed with the person. Senior care staff carried out assessments with people and or family members. Information was gathered about people’s needs in order to start writing a care plan.

People and relatives told us they were involved in their assessments and care planning. One person told us, “I know I can change it [visits] at any time. If something doesn’t suit me, I can say so.”

The registered manager told us they tried to make sure people had a quality assurance call after their first visit to check how the visit had been. People then had a 6-week review, and then a review every 3 months. This was to make sure the care plan and care delivery was right for the person. The registered manager said they often completed visits to people themselves to make sure the care being delivered was of a good standard. The registered manager told us, “I am on the rota so I can see what is going on . I talk with staff, and it is nice to see with my own eyes how things are. I have met with everyone; we know all of our clients by name and sight.”

The service was supported by a central office who provided guidance on national guidelines, legislation, changes to any regulations and areas of good practice.

People told us staff had worked with healthcare professionals to make sure their needs were being met.

Staff told us there was good teamwork and communication at the service. One member of staff told us, “Communication is important. We are told if there are any changes and [management] tell us in time. We also have respect for each other.” Another member of staff said, “There is good teamwork, we can discuss any problems with each other, with the registered manager and the care coordinator. All of us help to solve any problems and there is good communication.”

Professionals did not share any concerns about this quality statement. Professionals told us staff worked with others well and there was good communication.

Systems were established to make sure staff could communicate with each other. Any health concern was raised to office staff so healthcare professionals could be contacted.

People and relatives told us staff were good at noticing if there were any concerns regarding health conditions. One relative told us, “They [staff] would phone me and say we have contacted the district nurse, or I will phone them and say I have noticed something. We work pretty well together.”

Staff told us they supported people with their health and well-being needs. If any changes to people’s health were identified they would record this in the person’s notes and report changes to the office.

People’s care records demonstrated staff supported them with their health needs. People had care from the same core group of staff which meant staff knew people well. Early signs of ill health were identified so action could be taken in a timely way.

Relatives shared examples of how staff had worked to monitor and improve people’s outcomes. One relative said, “They [staff] are also monitoring bed sores and any skin issues. They also monitor drinking and make sure [relative] gets enough fluids.”

The registered manager told us any changes to people's health was identified through their review process or by staff when completing visits. Staff told us if people needed monitoring to improve their outcomes this would be added to the person’s care notes so they would know what information to record.

There was an electronic care planning system which held all care records. Staff told us if people needed additional health monitoring the relevant records would be added to the care plan system. This meant all staff visiting the person could see relevant monitoring information. Changes could be made to people’s records in a timely manner.

People and relatives did not share any concerns about this quality statement. When starting all packages of care, people were asked to sign a consent form to record their agreement to starting the service. Where people lacked capacity to consent, staff liaised with relatives who had Lasting Power of Attorney. This meant they had the legal framework to act on behalf of the person. One relative told us, “They [staff] will call the district nurse for us. Whenever they think that is needed, they [staff] phone me to ask, ‘we think he needs the district nurse can we have your permission?’”

Staff told us they understood the principles of the Mental Capacity Act 2005 (MCA). They told us how they made sure people were supported to make their own decisions wherever possible. One member of staff told us, “If someone has capacity they say their decision, they make their own decisions. I don’t take their rights or choices away from them. I am not in a position to stop anyone doing anything. If the person lacked capacity it would say on their file.”

We found a mental capacity assessment had not been completed for 1 person. The registered manager told us it was likely the person lacked capacity, but they would complete an assessment without delay. Where capacity assessments had been completed, best interest processes had been recorded. It was clear in people’s records who had been involved in any decisions and what support the person needed. Staff had received training on the Mental Capacity Act 2005 (MCA) and had access to policy and procedures.