Revelation Social Care Ltd

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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

A more robust assessment process was now in place involving the person and those important to them. These explored people’s social, emotional and physical needs. Care records clearly evidenced people’s mental capacity had been considered and consent had been sought with regards to their care and treatment. Managers and staff worked collaboratively with other agencies, so guidance and support were provided in specific areas of care and support. Good practice guidance had been embedded in people’s care plans, directing staff in the safe delivery of care and reinforced with staff training.

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 the relatives said they had been actively involved in the assessment and planning of the care and support required. We were told, “There is a care plan, there’s a copy here but of course they have it on their phones and they make their notes straight into their phone” and “I’ve seen a lot of the care and been involved in the care plan. I consider the good health and wellbeing of both my parents to have been down to the high quality of care from Revelations.”

Managers acknowledged improvements had been made to the assessment process, so care was only offered to those people the service was equipped to support. Managers carried out assessments prior to the delivery of care. Staff were made aware of people’s needs through a detailed care plan that was put in place and available on an App.

A comprehensive assessment process was completed. Information was used to develop people’s care and support plans. The agencies brochure guided people and those important to them on the referral and assessment process and how they would be involved in the development of the care and support plan. Advice and support were also sought from relevant professionals, so peoples assessed were effectively met.

People said they had access to the health care support they needed. Relatives said additional healthcare advice had been sought where the person’s needs had changed, for example, risk of choking or aspiration. One relative told us, “Staff have to follow speech and language guidance about thickening drinks, the pureeing of food and how staff should help with her meal.”

Managers said they would refer to relevant health and social care agencies, such as occupational therapists, speech and language therapists and community nurses, so relevant guidance was provided for staff in the delivery of people’s care and support.

The service worked in partnership with relevant agencies to ensure guidance and support was provided in specific areas of care and support. Good practice guidance had been embedded in people’s care plans, directing staff in the safe delivery of care. This included assessment tools in specific areas of support, such as, ‘Safe Feeding Guide’, where someone required a modified diet or ‘Stop and Pause’ when working with someone living with dementia. This helped to provide more personalised care. Managers had identified staff training was required in Dysphagia so good practice was followed whilst working with those requiring a modified diet. This involved using the International Dysphagia Standardisation Initiative’ (IDDIS) framework and how to work with key health professionals who may be involved in caring for an individual with dysphagia.

People spoke positively about the support they received and felt managers and staff were responsive in monitoring and identifying people’s changing needs. People’s relatives told us, “[Registered manager] noticed how I walked and made a referral, which resulted in having a built-up shoe, this has made a big difference for me” and “They [staff] overcame a pressure sore, working as set out by the district nurse. They let us know about any health concerns.”

Staff worked with other professionals to help meet people’s needs in a person-centred way. For example, they had received training from health professionals in how best to manage dysphagia. Dysphagia is when people struggle to swallow. Training had covered actions staff were to take to minimise the risk of choking, for example preparing thickened fluids to the correct consistency and ensuring time was taken when assisting people to eat any modified foods. Staff told us they were supported by other health care professionals, such as community nurses, GPs, and pharmacists. All communication, over the telephone or in person, was document ed on the electronic communication so information was easily accessible and shared across the team.

We found the service worked with a range of health and social care professionals who supported staff in meeting the needs of people. One healthcare professional told us, “I feel confident working in partnership with [person] carers.”

The introduction of the electronic care planning system had improved information gathered and shared between managers, staff and other agencies. A hospital passport was also being implemented helping to better co-ordinate people’s care and support following admission or charge from hospital so that continuity in care is provided.

Not everyone was in receipt of a regulated activity. Those people we spoke with said they arranged and attended any appointments independently or with support from family. One relative we spoke with said the health of their family member had improved, no longer needing healthcare input. People were also supported in areas of their life including following a healthy diet or accessing the local community. This was reflected in people’s care records.

It was evidence from discussion with managers, consideration was given to people’s social, emotional and physical needs when planning their care and support. Staff outlined the actions they had taken to encourage and motivate people to choose a healthier lifestyle. One member of staff described how one person had chosen to reduce their smoking habit. They were spending more time in the community with staff support.

Comprehensive care plans reflected how people were assisted to maintain a healthier lifestyle in relation to the health, social and emotional needs. Monitoring records were completed in specific areas so that changing needs could be identified and acted upon. Periodic reviews of people’s health and wellbeing were completed involving those important to them and relevant professionals helping to maximise their independence, choice and control. Staff had access to relevant guidance and training to help inform and support their practice.

Managers felt the new structure and designated roles were providing better oversight. Time had been spent reviewing the aims and objective of the organisations and their plans for improvement. Managers spoke about the on-going monitoring of people’s care and support. This was done through periodic reviews, and spot checks. In addition, managers said surveys had also been distributed, to staff, people and stakeholders, seeking their views about standards of care and further areas of improvement.

The service was developing systems to enable them to effectively monitor areas of the service. Audit and checks of the electronic systems including staff rotas and call monitoring, care plans, risk assessments, monitoring records were being reviewed. A monthly quality, risk and compliance report was procedure summarising findings from audits. These were linked to compliance with relevant legislation and levels of risk within the service. The service had introduced a newsletter’ High Risk Friday’, to help keep staff informed and develop their knowledge and understanding in areas of good practice and legal requirements. Additional staff training was also provided in specific areas to improve standards of care and support.

Where able people had been consulted with about their individual care needs. People told us their consent was sought prior to staff completing tasks. A review of people’s care records clearly reflected their choices and how they wished to be supported. People and their relatives told us they were regularly consulted with, adding “They maintain good communications with the family, with regular emails and meetings. [Relative] is able to be very involved” and “I’ve seen [registered manager] three or four times in the time I’ve been with Revelation, and we have spoken on the phone. I’m satisfied she knows my situation and the care has always been managed how I’ve asked for it.”

Managers told us they had improved systems to better evidence people’s capacity and consent to their care and support. Managers were able to demonstrate their knowledge and understanding of the Mental Capacity Act. We were told one person lacked capacity; managers were working with their family so decisions were made in their best interests. Staff told us people were able to make their own decisions. Staff provided people with options when providing care and support and respected people’s choices.

System had improved in relation to capacity and consent. Relevant policies and procedures were in place to guide staff along with relevant training. An easy read newsletter was also seen, addressing myths about the mental capacity act and what this means to people in relation to the decision maker, unwise decisions and if a specific diagnosis mean you lack capacity. A review of people’s records clearly evidenced consideration had been given to consent and capacity. Information clearly evidenced the involvement of people and those important to them.