Care Solutions Direct Head Office

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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

We assessed all 6 quality statements in the effective key question which has been rated good. This meant people were receiving effective care which met their needs. People’s needs were assessed and care plans were developed from assessment information. Care and support was planned and delivered in line with current practice, legislation and standards. People received appropriate support to meet their health, nutrition and hydration needs. Where people lacked capacity to consent, staff upheld their rights and acted in accordance with the Mental Capacity Act 2005.

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 family members felt involved in the assessment process and in decisions made about how care was delivered. For example, one family member said, “No concerns with her care, very organised, good with her reviews, respond promptly with any queries.”

The provider described the pre-service process which included seeking information from the person, family members and any professionals involved in the person’s care. The service manager explained that a senior care staff member was always allocated to provide initial care meaning further information and preferences could be identified and incorporated into the person’s assessment and care plan. Staff confirmed they were provided with all necessary information about people’s care and support needs.

There was a robust system to assess people's needs prior to the commencement of a care service to determine if they could safely meet the person’s needs. People’s care plans were current and reflected their choices about how and when care and support would be provided.

Family members felt people received high quality care. For example one told us, “I’m very pleased with the standard of care from all of the carers.”

Care staff told us their training enabled them to be able to deliver care and support in line with best practice. One staff member said, “We must monitor how much they drink, and some clients use thickeners so have to check this is the right amount.” The management team told us they had worked hard to ensure that care plans were individual, reflective of people’s needs, were fit for purpose and reflected guidance and advice of external health and social care professionals.

The provider commissioned with a policies and procedures company which meant they had access to a full range of relevant up to date policies and procedures. These also included forms and additional information to aid the smooth running of the service and ensure access to the latest best practice guidance. The management team and staff worked well with external professionals to ensure they were contacted when needed. Medical interventions were promptly sought, and care planning and monitoring processes updated following any advice received.

Family members told us staff and the management team worked well together and shared information to support the safe delivery of care. One family member said, “The carers discuss any changes in her care and health, very satisfied with her care.”

The provider described the handover process between live in care staff which was comprehensive and covered all aspects of the person’s care and relevant information about the person’s home. They also explained that they had access to people’s medical histories meaning they could be assured they had up to date information about the person’s health needs and medication. Staff and the service manager understood how to contact health and social care professionals should the need arise. Care staff told us they receive all necessary information at handover. One staff member said, “Yes it is a good team as the managers are always around to guide and give us room to ask questions if we don't understand. Other carers are there to cover my break. Yes we work with district nurses, there is continuity for the clients and the care workers.”

We requested information from partners however, we received no information relevant to this quality statement in response to our requests.

Records of interactions with health and social care professionals were maintained. Care plans detailed any changes to people’s health care needs and any actions or advice to be followed. Records and notifications we have received showed that care staff sought prompt medical support when required. Notifications are information providers ae required by law to send CQC.

People and family members were involved in regularly reviewing health and wellbeing needs where appropriate and necessary. Family members told us staff would support people to access medical support if required. A family member said, "Care staff point out if he needs to see the Chiropodist.”

Care staff confirmed they had received any necessary training to understand people’s health needs and the actions they should take to ensure these were met. One staff member said, “I have a lady who has improved in health both physically and mentally after we have been supporting her.”

Care plans contained information about the person's health, medicines and their wishes or decisions about the level of emergency care they should receive. Where we identified a need for additional information in relation to a specific healthcare need the service manager undertook to add this to the care plan. Care staff had received training to meet people's specific health care needs. Incident records showed that care staff had acted promptly and appropriately when there had been sudden changes in people’s health.

There were effective approaches to monitor people’s care and outcomes. A family member said, “Management staff did a routine visit with us last week to check we were happy with the service, very efficient.”

Care staff told us they undertook some routine monitoring of people such as ensuring they were receiving sufficient nutritional and fluid intake. The service manager described how they monitored daily care records which were completed via an electronic system and actions they had taken when they had been aware of any concerns.

Care plans and records of care completed by care staff were regularly reviewed by the service manager as part of the provider’s quality assurance process. People and family members were involved in reviews of care plans with changes made where required.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible and in their best interests, the policies and procedures in the service supported this practice. One family member told us, “His views are taken into consideration and he feels happy with the care he receives.”

Care staff told us they had received training around the Mental Capacity Act (MCA) and were able to describe how they would apply this in their day to day practice. One staff member told us, “Yes we did complete the training and sent the paperwork to the agency. We would always ask for consent from the client and would minimise risk.” The service manager understood their responsibilities and the actions they should take if they felt a person was unable to understand and consent to planned care. They also understood that some people were able to make unwise choices and others needed information presented in a specific way to enable them to continue to make choices and have control over their lives.

People’s capacity and ability to consent were taken into account as part of the assessment and care planning process. Care plans described how staff could support day to day decision making, reminding staff to allow people time to understand questions and provide a response.