Mayfair Homecare - Wycombe

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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

People's needs were assessed prior to the delivery of care and, where required, mental capacity assessments appropriately established whether people could make informed decisions about their care and support arrangements. The service encouraged people, their relatives and advocates to be part of processes to assess and review people’s care needs. This took a person-centred approach to explore people's views and wishes, including factors such as people's culture, communication needs, physical and psychological health needs.

This service scored 25 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff told us people’s care plans accurately reflected their care and support needs. Staff were satisfied care plans contained sufficient detail to enable them to understand and respond to people’s needs in a person-centred way. For example, care plans contained information about people’s culture and backgrounds and what was important for their wellbeing. Leaders confirmed they reviewed people’s needs regularly and in response to any changes required in the care they receive. Leaders explained how people’s communication needs were identified and met as part of the assessment process. This included establishing people’s preferred language and identifying staff with the required language skills to promote effective communication.

People's needs were assessed prior to the delivery of care. People and their families told us they were involved and supported through this process. They also told us people’s needs were regularly reviewed to ensure care plans remained up to date. Comments from people and families included, “They came round to ask what care I required and from there everything was put in place” and “They assessed what she needed and then they did a care plan. We have a copy and they come and update it maybe [after] 6 months.”

Records demonstrated people’s needs were regularly reviewed through assessment to ensure their support plans continued to reflect their current needs. For example, we observed 1 person’s care plan had been updated to reflect the palliative care they were now receiving. The service was in the process of introducing an electronic care system and people’s care and risk assessments had been updated on the new system. This provided a structured framework to promote a detailed and holistic view of people’s needs. For example, the assessment model included identifying people’s protected characteristics, life history, physical and psychological health needs, support needed with everyday activities, communication and sensory needs, and areas of risk such as mobility, skin integrity and environmental safety.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

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 told us their consent, views and wishes were taken into account during the planning of their care and support. One person explained, “I make my own decisions and they do what I want them to do. They don’t tell me.” A relative added, “I would say we have control about [person’s] care and the office are always helpful. I feel that the way they chat to [person] is helping her to keep engaged with what is going on.” Relatives consistently told us they were involved in decision making where this was required, for example, if a person lacked mental capacity to make a particular decision about their care.

Where required, mental capacity assessments were conducted to establish whether people had capacity to make informed decisions about their care and support arrangements. We observed one person’s care plan noted their capacity to consent to measures including bed rails which they had agreed to use for their own safety. Where people were able to verbally provide consent, but were unable to sign due to physical or sensory impairment, records made accurate reference to this. The service involved people’s representatives, such as relatives and powers of attorney, where required as part of decision making. Involvement in care needs assessments and reviews encouraged people to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests.

Staff understood the importance of obtaining consent and offering choices, and could describe how they promoted this where people experienced communication difficulties. For example, staff described supporting someone receiving palliative care. On some occasions the person was unable to communicate using speech. The person’s regular staff described how their experience supporting the person enabled them to interpret their facial expressions and work closely with the person’s relative to ensure they were working with the person’s consent. A staff member added, “On every visit…[I] explain what I’m going to do…[use] good communication, give choices, [makes it] easier for them to communicate what they want.”