Health & Alliance Home Care

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 service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always make sure people’s care and treatment outcomes were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. People did not have assessments of care and support which were based on recognised best practice tools. For example, the provider failed to use assessment tools to identify if someone was at risk of unplanned weight loss, skin break down or falls. Despite our finding people believed the care they received was good and met their needs well.

The service did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Although people told us they were involved in the planning of their care they were not involved in specific assessments related to their individual needs. For example, those living with dementia, or a specific mental health condition did not have assessments linked to their known conditions. Therefore, the care planned did not account for them as a whole individual with specific issues which mattered to them. Despite this people felt the staff supporting them knew them well and supported them as they wished.

The service did not always work well across teams and services to support people. One supporting healthcare professional had raised a concern about a person’s specific condition. They had requested an assessment be done in order to manage this. However, we saw this had not been completed and the registered manager could not provide a reason why. This put people at risk as information required by other healthcare services was not readily available should they need to intervene.

The service did not always support people to manage their health and well-being, so people could not always maximise their independence, choice and control. One person had a noticeable change in their well-being which had been identified by staff supporting them. However, the management team did not complete a reassessment of the person’s needs, a risk assessment or guidance on how staff were to support them. Although the person themselves could self-refer to additional services there was no assessment or information from the provider on how they were to support the person through those changes.

The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. As the provider failed to complete base line assessments of people’s needs, they did not have comparisons in place to monitor changes in needs. For example, the provider did not identify those at risk of weight loss and did not monitor changes to identify potential triggers for further interventions. Despite our findings people and relatives were positive about the support provided. One relative said, “[Relative’s name] care was fully discussed, and the carers were very good at noticing any changes.” However, these changes did not always result in a reassessment of need or changes to the care plans to ensure consistent care was provided.

The service did not always tell people about their rights around consent and did not always follow recognised best practices when decisions were being made. The provider did not have systems in place to identify and empower people to make decisions for themselves. They could not demonstrate they understood or applied the principles of the Mental Capacity Act (MCA) 2005. For example, the provider supported people whose ability to make decisions may have been impacted by reason of dementia or mental health problems. Requests were made by the provider for these people to sign consent documentation without an assessment of capacity to make such decisions. The provider also failed to demonstrate an understanding of the application of the best interest decision making process. However, despite our findings people and relatives felt staff asked permission to perform care prior to doing so and engaged them well in general day to day decisions.