Covenant Healthcare Ltd Also known as Heritatge Healthcare Coventry

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. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People's support requirements were assessed before they joined the service and continued to be reviewed as their needs changed. Relatives told us they had been asked for their views across a wide range of areas relating to their family member’s health, emotional and communication needs and preferences. This information contributed to the development of people’s care plans and reviews, so people's wishes, choices and changing needs were addressed.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff supported people with complex physical health needs including a PEG [Percutaneous Endoscopic Gastrostomy tube], or RIG, [Radiologically Inserted Gastrostomy tubes]. People may need a PEG or RIG tubes if they have difficulty swallowing or cannot get all the nutrition or medicines they need by mouth. Staff were provided with training and were now supported to provide good care through detailed guidance, which was based on national best practice standards, such as The National Institute for Health and Care Excellence, within people’s care plans. This included guidance in relation to how much water to use to ‘flush’ people’s PEGs. Other people managed their meals, drinks and snacks independently or with support from relatives. People's care plans prompted staff to ensure people were left with drinks at the end of their care visits, where appropriate.

The provider worked well across teams and services to support people when people moved between different services. People gave examples showing how staff supported them so they could have access to other health services when they wanted it. One person said, “The staff were quick to get me into hospital when I was violently [ill].” Relatives told us staff advocated for people and supported their family members when their needs had changed. One relative said, “Staff will say if [person] is a bit pale or quieter than usual, they let us know, or occasionally they have let the office know, [person’s name] may have a [urinary tract infection] and I organise for the GP to come out.” Staff told us senior staff supported them to remain with people until emergency services arrived. Staff understood the importance of communicating essential information, such as the medicines people were prescribed and had been administered, to other health and social care professionals. Staff liaised with people’s families, or directly contacted other health professionals, when people wanted support for routine health appointments, such as with their GPs or district nurses. Staff were positive about arrangements put in place to assist them to work across teams and told us there were regular opportunities for meeting and working with staff at all levels within the organisation. This was backed up by regular written communication through information technology platforms and feedback resulting from spot checks on staff practice.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. People told us staff carefully monitored their health and escalated any concerns to their healthcare providers. One person told us staff quickly contacted emergency services and stayed with them until an ambulance arrived, when they had become very ill. The person told us they had recovered well. Staff gave examples showing how they supported people when their health had declined, and explained how they worked with people, their families, and other health and social care providers, so people would have prompt access to the healthcare they wanted.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. People told us there had been improvements in their health which had been contributed to by the care they received from staff. One person said because of this, they were able to remain in their home, as they wished to. Relatives were confident staff would take appropriate action to identify changes in their family member’s health and to secure assistance for them when needed. Staff gave examples showing how they monitored people’s physical and emotional health. One staff member told us if they were concerned a person’s health was starting to deteriorate, “I would also see how they are doing on a later [care] call, to see if there was a difference between [care] calls.” The staff member described how they would escalate any concerns to other health professionals as appropriate. However, we found there were some inconsistencies in staff recording people’s fluid outputs, where people’s care plans indicated monitoring was required. There was no evidence of harm to people, but this increased the risk any change in people’s health support needs would not be promptly identified. The registered manager immediately took action to resolve this.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People told us staff checked if they agreed to receive care before starting to provide it. One person said, “Carers, [staff], always ask what I want.” Staff gave examples showing how they checked people's body language before starting to care for them, so they could be sure people were agreeing to the care being offered. Staff understood some people may not be able to make all their own decisions. One staff member told us about the approach taken by staff to ensure people’s rights were respected under these circumstances. The staff member said, “It’s about the best interest of the [person].” The provider had identified where other people may have the legal right to make some decisions on behalf of people. People’s capacity assessments now reflected their personal histories and diagnosis and considered their capacity to consent to a wide range of elements of their care. However, we continued to find some people’s assessment erroneously contained a standard sentence about people’s capacity to consent. We found no impact on the care provided to people. The registered manager agreed to review this.