Adonai Healthcare Services Also known as Adonai Services Limited

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 received appropriate care in line with their needs through staff support as well as input from healthcare professionals. Staff worked well with external agencies and followed advice and guidance given. Staff received a range of training to help ensure they were confident and competent in the role and where people lacked capacity appropriate measures were taken to help ensure the principles of the Mental Capacity Act 2005 were being followed.

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 confirmed their needs were assessed prior to the agency accepting them as a care package. Relative’s told us, “Yes, there was an assessment and his needs have altered and the carers report back and we will get a call to ask if we need anything changes” and, “Yes (there was an assessment) and it has been updated quite a few times and recently at every stage of dementia the care plan was reviewed.”

The registered manager told us they had not taken on any new clients since our inspection in 2023. They said, “Because of our rating, the local authority would not commission with us, so we have not been able to take on any new service users. However, if service users go into hospital then we would always re-assess that person before we started to provide the care package again.” They told us, “When we develop a new care plan staff can see this straight away. We ask all staff to read this and we can track which staff have. It’s important, even if staff will not be going to that person, that they know people just in case they need to provide care in an emergency.” They went on to say, “However, if I assessed someone who, for example, required to be fed through a PEG tube, I would not take on that care package as staff have not been trained. That would cause a safety issue.”

Systems and processes to help strengthen the quality of assessments and care documents had improved since our last inspection. The registered manager or care co-ordinator carried out initial assessments for people and within 48 hours a skeleton care plan would be in place. This would be readily available to staff on the electronic system.

People were happy with the appropriateness of staff’s input. A relative told us, “They have picked up his UTIs (urine infections). He has to have a special wash and cream and the staff area really good.”

Care plans held generic information about people’s healthcare needs, such as diabetes or kidney disease. The registered manager told us, “We use the guidance consultants send us and we also print off information ourselves to add to a person’s care plan. We always use additional guidance, such as the British National Formulary for medication.”

People’s care plans contained information about their care needs which included national guidance where appropriate. Some people had diabetes and there was information about hyperglycemia (high blood glucose levels) and hypoglycemia (low blood glucose levels). This helped staff understand the signs and presentation of these conditions and act appropriately.

A relative said communication between management and external agencies was good. They told us, “She has a catheter and can pull it out. When staff notice, the care co-ordinator calls me so I can contact the nurses and arrange for them to come. Staff have dealt directly with the district nurses when we haven’t been around.”

The registered manager told us they had better links with external professionals. They said, “We deal with every professional who is involved with the person’s plan. We incorporate them into the care and can reach out to them to ask a question. [Care co-ordinator] referred one person to a charity to help support them as they were in need and we also contact people’s social workers, the GP, their pharmacy or the dietician when needed.” A staff member said, “I remember we had a client who was withdrawn and needed to see a social working, she was neglecting herself. So I escalated it to the office and they helped immediately. They arranged for the social worker to go in.”

External professionals had carried out a review of the agency since our last inspection. They reported finding improvements and that the agency had worked to address all of the shortfalls we had identified.

Management worked with external agencies and professionals to help provide the most appropriate care to people and to help ensure that people were not at risk of harm from unsafe practices by staff. Training for staff had improved since our last inspection. Training modules had been consolidated and all staff now received training through Skills for Care. This meant training was consistent and management were able to easily monitor when refresher training was required. Staff reported concerns about people to enable management to make appropriate referrals or contact with professionals as and when needed.

People were supported with their health needs. Relative’s told us, “They’re all aware of what he has to eat and where it is. He’s allergic to everything and the carers are really good” and, “She has nutritional drinks now and staff keep on top of this.”

Management worked with families and professionals to support people live a healthier lifestyle. The registered manager told us, “In particular where people require a special diet, such as if they were diabetic, we would speak with the dietician for advice.” A staff member told us, “For instance, if there is food they don’t eat so the staff make sure we don’t give them anything different from their care plan.”

Systems were in place to enable staff to make referrals to external health professionals when needed. Staff knew how to escalate a concern or deterioration in someone’s health, so the registered manager could take appropriate action in response.

Relatives felt positive about the way their family member was looked after. Relative’s told us, “He needs so much, they can’t go quick. We have a system going now and we are quite happy. I have one of the most experienced care workers. She knows what to do and to record any changes”, “She wouldn’t have looked after herself at all if it wasn’t for them (staff) and their care. Her blood pressure was dropping and they have turned it around as they keep on top of it” and, “She is now walking to the toilet. Her rehab is due to the girls supporting her.”

With the input of staff, people had improved. The registered manager told us, “When we first provided care to [person’s name] they could not walk. Now, with staff support, they can walk to their bedroom and around their house. Another person had pressure ulcers and [staff name] worked massively with them and the nurses were amazed that [person’s name] skin is intact.”

People’s care needs were reviewed regularly to help ensure they were receiving the care they required. Care calls were adjusted accordingly and time with people increased if they deteriorated. Staff recorded daily care notes which detailed the care provided to the person and identified or highlighted any areas that required addressing.

We were told staff gained people’s consent. People said, “They always ask me. They are very polite.” A relative told us, “They do and they do ask me.”

Staff had undertaken appropriate training. The registered manager told us, “Staff have had training and I have come up with a knowledge test for staff around mental capacity. I will be incorporating this into staff supervision, although it is not yet embedded.” A staff member told us, “I tell them what I am doing and what I am about to do.” A second said, “It’s a guide and we have about five principles which are a presumption of capacity, best interests, less restrictive options and unwise decisions, making sure we can’t force clients.”

Improvements had been made since our last inspection and management were following the principles of the Mental Capacity Act (2005 ) (MCA). Staff received training in the MCA and had a good understanding of it. Management held evidence where family members had power of attorney in health and welfare and as such where they were legally able to make decisions on people’s behalf. People’s capacity was assessed when this was needed and people signed their consent to their care package where they were able to.