Fen Homecare

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

People told us they had access to their care plans and felt involved in their care. The provider acknowledged further work was required to ensure care plans were both up to date and accurate. Staff sought consent before providing care, but formal capacity assessments were not always completed when needed. The service was not consistently compliant with legislation or best practices, and staff training did not always align with individual needs. Care records lacked detailed information about health and social care professionals. While people and their relatives were satisfied with health-related support and provided periodic feedback, the provider's approach to monitoring and improving care was ineffective.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People felt involved when the service began and reported that a staff member visited them to discuss their needs and create a care plaan.

Staff reported that they knew people well, understood their needs, and typically supported the same individuals, helping to build trust. They stated that they were introduced to new clients and reviewed care plans before providing care. Staff felt they had the necessary information, and the manager confirmed that assessments were conducted before starting a service to ensure needs could be met.

Although care plans were in place, it was unclear when they had last been reviewed or if the information was up to date. We saw an example’s where care plans were not up to date with the correct information about someone’s physical health. The Registered Manager stated that the staff member responsible for reviewing care plans had left, and no one had been appointed to take over the role. During the assessment, the provider employed a consultant to review and update the care plans.

People and their relatives provided mixed feedback about the care they received. They felt that staff knew them well; however, some expressed concerns that language barriers, when care staff’s first language was not English, sometimes affected the quality of care. People reported that staff did not always understand their food preferences, which impacted their experience.

Staff did not express concerns about the training or support they received from management in staying up to date with legislation, good practice, and required standards for their roles. However, our findings showed that staff support and training did not always align with best practice or comply with current legislation.

The service was not always aware of or compliant with legislation, current evidence-based good practice, and standards. The provider and registered manager had not ensured that staff training included meeting people’s specific needs or reflect best practice in meeting them. We identified instances where the service failed to follow best practice guidelines, such as the absence of pain assessment tools for people living with dementia who were unable to verbally communicate their pain.

People and their relatives told us how staff helped them to access healthcare professionals when needed.

Staff told us they had worked with people for a long time so knew how to meet people’s needs. If information changed they stated they were made aware so that they could access the care plans. However, we found care plans were not always updated as people’s needs changed. The nominated individual spoke about their liaison with occupational therapists in relation to people’s care equipment. The registered manager spoke about how they worked with people’s GPs and district nurses.

We did not receive any feedback from external health and social care professionals about how they worked with the service

People’s care records we looked at contained very limited information about the health and social care professionals, teams and services involved in their care or how staff worked and shared information with these. This did not fully promote joined-up care and effective working between teams.

People and their relatives were satisfied with the support they received from staff in relation to their health needs. People’s relatives confirmed staff responded to significant changes or deterioration in their family members’ health.

Staff felt they had the information they needed to meet people’s needs and they did not raise any concerns in relation to supporting people with their health needs. The registered manager described how they would support people to see their GP, by helping them to make appointments or arrange a home visit.

People’s care records did not always contain clear information about their long-term health conditions or the role of staff in monitoring and supporting them. Additionally, staff training records showed that staff had not received awareness training on known long-term health conditions, such as diabetes, despite care plans stating this training should be completed. Following our initial findings, the consultant employed by the provider planned to deliver training on people’s health conditions.

People and their relatives gave mixed feedback about the outcomes of the care they received. One relative told us, “If I say something, they generally do something about it. They’re not perfect but the issues aren’t something I can’t get resolved."

Staff did not raise any concerns about the outcomes people experienced from their care. They spoke positively about the overall service provided. The provider told us about positive outcomes for people such as pressure sores healing. However, this progress and outcomes were not recorded in people’s care plans and records.

People and their relatives were invited to complete periodic feedback surveys, to ensure the outcomes of their care were positive and their expectations were being met. The registered manager stated that they analysed this feedback but could not provide the findings of the previous surveys. However, the provider’s broader approaches to monitoring and driving improvement in people’s care were not effective. They had not enabled the provider to identify the shortfalls in quality and safety we found during this assessment, and the preceding inspection, including concerns around the management and assessment of risk.

Relatives felt the registered manager sought their opinions and valued their feedback regarding consent to care and treatment.

Although staff could tell us how they offered people choices, action had not been taken to ensure that when people could not consent to care and support the correct procedures were followed. The provider told us that not all the care plans were accurate about whether people had the capacity to consent to their care and support.

The provider’s systems and processes did not fully ensure that people’s rights under the Mental Capacity Act (MCA) were consistently protected. When needed, not everyone had evidence of decision-specific capacity assessments to demonstrate how their ability to make specific care decisions was evaluated when they lacked capacity to consent. Care records contained inaccurate and contradictory information about individuals' communication abilities and decision-making capacity. These inconsistencies did not align with the MCA’s principles, particularly the requirement for capacity assessments to be decision-specific.