Assured Care Southport

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

Our rating has changed from inadequate to good. The provider had not assessed any new people to the service since our last assessment, however a full review of the current needs of existing people who used the service had been assessed, detailed assessment and updated care plans were in place. Further work was still needed for a small number of people to ensure a suitably trained professional had input into one aspect of their care plan. The registered manager put plans in place for this during our assessment. Records demonstrated when people had consented to Assured Care Southport providing them care, however, further work was needed to ensure assessments of people’s capacity to consent were decision specific in line with the Mental Capacity Act 2005. People were supported appropriately to access the service of other professionals to ensure their physical health needs were met. This included arranging and attending appointments with people when appropriate. Outcomes for people were reviewed on a regular basis with people and family members where this was appropriate.

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 confirmed they received an assessment of their needs at the start of their care agreement with Assured Care Southport. They, and people important to them were consulted about how they wanted to be supported. We were told by one person, “In the beginning I had a long interview with them. I had a booklet to fill in and we discussed everything. Likes, dislikes everything. They included my husband in those conversations.” People also confirmed they had regular reviews of their care when they could make changes. Comments included, “[My care was] reviewed twice last year and once this year, very thorough” and, “If I go into hospital, they are straight round when I come out and get the ball rolling again.”

Staff were able to describe the referrals and admissions process in place. This included how the management team made them aware of any new people and their needs, or when existing people’s needs changed. A staff member explained, “[The management team] come out to do an assessment to see needs for care and then will write out a care plan." The registered manager also confirmed they would always undertake a face-to-face assessment of a person, and their home environment before commencing a new package of care to ensure their needs could be met.

Since our last inspection there had not been a new person in receipt of care at Assured Care Southport. However, all care plans for existing people to the service had been reviewed. We reviewed the referral information for people which was available and the planned care visits and confirmed peoples care was being delivered in line with their assessed and agreed needs.

People told us they received care which was in line with good practice. People told us staff were knowledgeable and worked with them. A family member told us, “We contact each other and pass on information. And keep in touch so I can send them messages if I want something.” A person who received care said, “Communication with the office is amazing. I talk to the office, and they sort it out. We're on the same page, we keep each other up to date.”

Staff described ways in which they worked with people to plan and deliver care. This included communication methods to maintain this such as completing communication books. Staff also confirmed they had received training and guidance around people’s specific care needs and described ways of supporting people which was in line with best practice. For example, how to assist a person who has a modified diet due to a risk of choking and how to promote healthy choices to a person with diabetes.

Staff had access to evidence-based guidance. Care files in people’s homes contained best practice guidance regarding any specific care need they had. For example, signs to look out for when a person is a risk of pressure related skin damage. However, two people required assistance with an intimate care task. Although there was a care plan in place we were unable to see how this had been developed based upon professional guidance. We spoke with both people who were happy with the skills of the staff and staff had received recent training which included a check on their competency, so we were satisfied there was no risk of harm however, we raised this with the registered manager. The registered manager then arranged for a review of these care plans by a medically training professional to ensure they could demonstrate guidance for staff was in line with legal and best practice guidance was followed.

People told us staff worked effectively with them and other agencies to ensure their needs were met. Comments included, “[Staff] work well together, like one big family. There is good communication with the office. I will ring the office straight away if concerned” and, “I have an exercise call. [My medical team] have given me splints and techniques I can do. [Staff] help me. I've lost the plan, so staff have remembered what to do.”

Staff described how they worked effectively with other agencies to ensure people’s needs were met. The registered manager gave us examples when they have contacted other agencies to support a person through a particular health need. However not all staff thought internal communication systems were always effective. For example, a staff member told us they heard about a recent hospital admission of a person from the relative, not from the office-based staff.

We received mixed feedback from professionals who worked with the service about effective partnership working. Whilst feedback from health professionals was positive about multi agency working, we received feedback the service did not always provide assurances or information to local authority teams in a timely manner. We shared this feedback with the registered manager.

Systems were in place to demonstrate when staff had interacted with other agencies to effectively support people. Information was recorded in daily care notes, as well as any advice or guidance provided. For example, we reviewed records following staff identifying pressure areas, following attendance at medical reviews and when support had been sought following a series of falls for one person.

People provided examples of how staff supported them to live healthier lives. This included accessing health services or the doctor if they were feeling unwell. Comments included, “[Staff] have taken me to doctors’ appointments. They have spoken up for me. Sometimes we write the questions down before we go” and, “[Staff] would contact the Doctor if I was unwell. If I go out and am not here when they call, they will always check up on me. Make sure I am ok.”

Staff confirmed the process they would follow if a person was unwell. Staff also gave examples of how they encouraged people to live a healthy life including taking exercise and lifestyle choices. One staff member said, “It is personal choice, I have to be mindful of that. I would never take choice away. I would promote hydration, healthy options [to eat].”

Staff recorded medical appointments made for people through the daily care notes and their outcomes. Risk assessments and care plans identified individual needs with regard to living a healthy lifestyle and how to promote this whilst respecting personal choices made by people.

People spoke positively about the impact the support provided by staff from Assured Care Southport had made upon their quality life. One person said, “Before the carers came, I would stay in bed all day. I wouldn’t wash or eat properly, had no hobbies and wouldn’t go out. Great improvement. I go out with them, I shop, I do gardening and they help me cook. I feel more hopeful now, [I have] something to get up for in the mornings.” Another person told us, “[Staff] make me feel better. They lift my spirit. At first, I didn’t want them and now I would miss them. Although they are professional, I look at them as friends.” People also confirmed their care was regularly reviewed and they had the opportunity to review and make changes.

Staff demonstrated they understood the importance of getting to know what was important to people to improve their personal outcomes and goals. Examples included supporting people to access their local community and to improve their general wellbeing. One staff member told us, “We just keep doing what we are doing, always leave [people] with a smile. I always work Christmas day, provide lunches/crackers etc.” The registered manager described the process for reviewing peoples care with them every three months as a minimum.

People’s personal goals and aspirations were identified through care plans, along with guidance for staff how to support this. For example, one person was aiming to reduce their usage of pain medication, another person who was living with dementia wished to remain living in their family home for as long as possible. We saw both care plans had been regularly reviewed with the person and, where appropriate close family members.

People told us staff sought their verbal consent before assisting them with care. Comments included, “[It is] always a two-way conversation. Whatever I want to do” and, “I have a shower 3 times a week. Sometimes I don’t want one and that’s ok. [Staff] will assist me to have a wash instead. I decide what I want to do.”

Staff told us they had received training in the Mental Capacity Act 2005 (MCA) and were able to describe examples of how they ensured people consented to care. One staff member said, “Yes, I always ask consent. ‘How do you feel about having a little wash? would you like to freshen up?’ I would never say ‘you are going to have a wash.’ How this is communicated is important, I build a relationship to encourage people.” If a person refused an aspect of care, staff explained the actions they would take to encourage the person, whilst respecting the decision the person had made. One staff member said, “I would contact on call manager and record in the notes that they had refused care or treatment. You cannot force, people have free will and choice. I would not force [care] on to somebody if it was their wishes.”

At our last inspection, we found processes were not robust enough to ensure people were supported to make decisions about their care and treatment. At this inspection we found significant progress had been made however some further work was still needed. Action had been taken to demonstrate people who were able had recorded their consent to care. Where they had chosen other people to represent their views, this was recorded. Where a person was unable to consent, a mental capacity assessment had been completed. However, this was not decision specific in line with the principles of the MCA. Another person’s family member had signed on their behalf but without evidence of holding any lawful authority to do so. We raised both examples with the registered manager who took immediate action to review.