First Homecare - North London

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.

This is the first inspection for this service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to consent to care.

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.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. The person’s needs had not been fully assessed or recorded within their assessment. Feedback from staff about the person’s needs was inconsistent with information highlighted within the initial assessment. The provider had also not liaised with other health and social care professionals who had been involved in the person’s care to help them get a better understanding of their needs to support their own care planning. However, we received positive feedback from the person’s relative about the initial assessment and how detailed and thorough it had been.

The provider did not always plan and deliver people’s care and treatment with them in line with best practice. For example, where staff were carrying out care and support to meet a person’s nutritional needs, the provider had not sought advice in line with current evidence based good practice and standards. However, they had discussed this with the person’s relatives and staff as part of their care planning and staff could explain in detail the level of support they provided.

The provider worked well across their teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. A relative told us how staff worked closely with them, as due to the funding nature of arrangements for their care, it was managed directly by people or their relatives. The relative added, “The carer is very involved in dealing with the care needs and liaising with other agencies, such as the pharmacy or the GP. They have supported [family member] to appointments and will sit in with them and answer questions. This is helpful as they are then able to tell us about the appointment as [family member] wouldn’t be able to."

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. A relative told us staff were constantly checking their family member’s health and wellbeing, which they could also monitor via the provider’s digital care planning system. Samples of daily logs showed the person was regularly supported to get fresh air, eat a balanced diet and to keep up their mobility to support their wellbeing. Feedback confirmed the positive impact the care and support had on the person’s wellbeing and improvement in their overall health.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent. A relative and staff members told us about the benefits they had seen due to the level of care provided, especially since they first started. A staff member added, “As it is a live in care package, we are regularly checking and monitoring [person] and they have massively improved compared to before. However, the provider acknowledged they could be more proactive in liaising with other health and social care professionals to ensure they met both clinical expectations and the expectations of people themselves.

The service did not always tell people about their rights around consent and did not follow recognised best practices when decisions were being made. The provider did not have systems in place to identify and empower people to make decisions for themselves. They could not demonstrate they understood or applied the principles of the Mental Capacity Act (MCA) 2005. For example, a mental capacity assessment had not been carried out or recorded at the initial assessment. This meant staff did not have the appropriate information about whether people had capacity to make specific decisions about their care. The provider also failed to demonstrate an understanding of the application of the best interest decision making process, which was not in line with their own policies and procedures. However, despite our findings a relative said, “Despite the cognitive issues, the carers will always involve them, communicate with them and seek their consent throughout all care tasks. Nothing is forced."