London Borough of Hackney, Housing with Care

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’s needs were assessed before they began to use the service and this was a collaborative discussion with relatives and relevant health professionals. People’s consent was requested before care was delivered and staff respected people’s right to refuse. Independence was promoted to enable people to feel a sense of accomplishment and control over as much of their life as possible.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they had their needs assessed before they started to receive care and support, relatives confirmed this as well. People were involved in the care planning process and where people had family support or additional support they were also involved. A relative said, “I have power of attorney. A care plan was made and I was involved. Two to three staff came, and we had a long conversation about [person’s] needs. Yes, there have been times when it has been reviewed as their needs changed.” Another relative said, “A care package was done. Mine and [person’s] views were very much listened to. There have been reviews. Every little change is introduced into the care plan. Like the use of a brace by the occupational therapist. I sign it and so does [person] as well as the manager. Relatives told us their family members needs were regularly monitored.

The registered managers explained the care planning process and how people were actively involved in this along with a different health professionals. Scheme managers knew people’s needs, were involved in care planning and received information from staff on any changes in people’s current health needs to ensure care provided was up to date.

People’s health records confirmed there was a needs assessment before they began to use the service. This was to ensure they were suitable for a particular scheme and their needs could be safely met. Records confirmed there were regular reviews of needs as required, involving people, their relatives and health professionals. Where needs had not changed they were reviewed along with risk assessments annually.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

People were supported to access healthcare with help from staff. A person said, “The staff help me with doctor and hospital visits. They help me with other healthcare. Their help is good.” Relatives told us they were informed of changes in their family members health and told of health appointments that were needed.

Staff we spoke with confirmed they had good working relationships with health professionals for the benefit of people. A member of staff said, “Yes, we work with the GP, occupational therapy, district nurses, pharmacist, dietitians and dentist.” During handovers information was shared between staff and managers about people’s health needs and to ensure staff were aware of any future appointments.

There were also records of health and social care professionals involved in people’s care and feedback from them was positive as they documented measures needed to improve people’s health had been implemented. For example, the occupational therapist had recorded alternative moving and handling techniques for staff to use and upon review had stated there were improvements in the persons well-being.

People were encouraged by staff to be independent where possible. One person said, “I can eat myself and go to the bathroom. The carers help with personal care and with getting me dressed.” People told us they were supported to attend health appointments and they appreciated this support from staff.

Staff helped encourage people’s independence as much as possible, but this was not forced. Staff told us they also tried to support healthy living through nutrition, activities and exercise. For example, records around nutrition were clear and staff followed this in particular where people had diabetes and staff had to be vigilant to respond to a change in their health presentation.

Observations confirmed District nurses attended to administer insulin to people living at the different schemes which was important for people to stay healthy. Care plans were in place recording how people were to be supported in a personalised way.

People and their relatives told us they were pleased with the support they received, and relatives told us they could see improvements in the health and happiness of their family member. One person said, “Staff take me to the hospital and have taken me to the G.P. They fix my appointments. Last year they got me an ambulance to the hospital. Carers were quick. I went to the hospital for my teeth and staff got me there safely.” A relative said, “I’m very impressed with the care they deliver to [Person]. [Person] has dementia. They explain what they are doing when they put them in the hoist. [Person] was laughing with them. They make it respectful and reassure [person].

Staff demonstrated they were aware to monitor, record and report changes to people’s needs and health to ensure they received appropriate and timely care and treatment. A member of staff told us the chain of command they follow to report changes in people’s health needs. In the case of an emergency staff knew to contact emergency services.

During reviews and feedback sessions people’s views were reviewed and monitored. Records confirmed the quality assurance processes picked up on people’s views and these were followed up with the person to ensure the required outcome for people was to their satisfaction. People’s care plans documented their goals, and these were reviewed with staff to keep track of progress.

People told us staff asked for their consent before care was given to them. One person said, “They ask me first for permission. I’m a human being. They say, “Can I do this or that?” A relative confirmed they observed consent to care being requested by staff before support was provided to their family member and their right to refuse was respected. A relative said, “I’ve seen them ask [person] first and I’ve seen [person] refuse. [Person] will say I can do that myself. They [staff] have respected that.”

Staff were aware to seek people’s permission before providing care or treatment. Staff told us they asked for consent before any moving and handling was delivered, personal care and the administration of medicines. A member of staff said, “We give people time to understand what is being asked, we don’t assume anything.” Another member of staff said, “I respect people’s decisions and ask for their consent before doing anything.” Staff received Mental Capacity Act 2005 (MCA) training and understood the importance of supporting people to make their own decisions as much as possible.

Care records clearly stated consent was requested and where people were unable to sign, details of who had given consent was documented. The principles of the MCA had been followed and mental capacity assessments were completed where people were deemed to lack capacity to make certain decisions about their health and daily living. Where relatives had power of attorney for health and welfare, to make decisions on behalf of relatives, this was recorded within care plans.