First In Care Services

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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

Staff assessed people’s individual needs with them. Their care, support and treatment reflected these needs and any protected equality characteristics. Staff worked well with other services, so people could live healthier lives. Staff supported people in line with the Mental Capacity Act 2005 (MCA) which protected people’s rights. Staff worked in line with current national best practice guidance and were aware how to address people’s specific health and care needs appropriately. People experienced consistent and person-centred, timely care which resulted in good outcomes.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were happy how their care needs were assessed and met by the care packages provided.

Staff and managers were knowledgeable on how people’s needs were assessed and reviewed when they started using the service. One staff member told us about how care plans were created and added, “Risk assessments are done by the registered manager before people’s care begins. If I notice deterioration, the first point of call is always the manager to report risks to. I would still provide a service in the best way possible until they are re-assessed and ask what would help the client.”

The provider had a clear process in place for assessing people’s needs before they started using the service. People’s care records confirmed staff followed the process, as every person had a personalised care plan in place.

People and their relatives told us staff knew how to meet their needs and provided good care.

Staff were aware of good practice in relation to, for example, dementia care, supporting people to eat and drink enough or to mobilise safely. One staff member said, “I follow [person’s] care plan as some people can only have a certain amount of fluid at any one time or in a day. If [people] are not eating, I explain the benefits to them of eating and drinking properly, how it can stop them from becoming ill. If I noticed that they are not eating or drinking enough, I will escalate to my line manager.”

People’s care records confirmed their care was delivered in line with best practice guidance, for example, around supporting people to avoid malnutrition and dehydration or supporting people living with dementia.

People said staff worked well as a team which enabled them to provide consistently good care. People said, “My carers will sort anything for me, and my daughter will contact the manager for me if needs be. I don’t have any issues as I am very happy with everything as it is” and “I have a mix of staff and they all seem to know my situation.”

Staff knew how to work together as a team and with other partners to deliver good care. One staff member told us, “I have to contact the office quite a bit and the communication is always good and responded to quickly. [The registered manager] always answers my calls, if she doesn’t, she will always ring me back. I am confident that she will sort things. Most of the time, if I call up to report something, she will come out to the client to assess the situation for herself.”

Staff worked well with social care and healthcare partners which was visible in the correspondence we reviewed during the site visit.

The registered manager and staff had clear understanding of processes in place to provide consistent and relevant support to people as and when needed, working with healthcare and social care professionals and people’s families. People’s care records showed this was implemented.

People said their care was good and they would be able to access support to contact healthcare services as and when needed.

Staff knew how to work well with healthcare services and gave examples of how they supported people to stay well or to get help when needed. Staff members told us, “If I think there is something that needs to GP involvement, I will contact my line manager and take their advice. If they were visibly poorly, I would call an ambulance”, “I had to ring the GP when [person had certain symptoms at night]. I contacted my manager to give her background and she advised to ring 111 at that moment. I stayed until the paramedics came and then stayed until [person] felt better.”

People’s care records included information on support required to contact healthcare services and their individual health needs.

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 and their relatives said staff asked for their consent for care. A relative told us, “[Staff] ask [person] first before they do anything.”

Staff knew about Mental Capacity Act 2005 (MCA) and their responsibilities, how to ensure people’s consent is sought and what to do should people lack capacity to make certain decisions for themselves. Staff members commented, “I always ask the clients consent first (before supporting them)”, “If someone is able to make decisions around their care, then this is fine. If not, we have MCA policy in place, and where possible will help them to make a decision that is best for them. This will always be in their care plan”, “MCA is in regard to always acknowledging person is capable of making their own decisions. If not, then their capacity is assessed. It is not disregarding the person but working in such a way as to take their best interests into account. To never force them (to do anything); to always encourage them.”

People’s care records included information around their consent, mental capacity assessments and best interests decision made when relevant, and information about people’s legal representatives.