Care Outlook (East Sussex)

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.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This is the first assessment for this service following a change in provider. This key question has been rated good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The registered manager told us that they and the deputy manager carried out most of the pre-assessment visits. They visited people mainly in their homes but sometimes in hospital and carry out a full needs assessment with the person and their relatives or advocate. Only if they were happy that they had the staff with the right skills and experience would they accept a new client. The pre-assessment would form the framework for the person’s care plan and any risk assessments would be completed. All of this information would be shared with staff before starting care calls. After six weeks or sooner if there were a change in circumstances or specific need, the care package would be reviewed to ensure it continued to meet people’s care needs. A staff member said, “Manager will tell us about new clients before we start.” Another added, “Before a new client starts, it’s all explained. All information is in plans and we can update on our phones.” People and their loved ones confirmed they were involved in the pre-assessment. Comments included, “I was, the first time they came to the house we discussed everything in detail. Further assessment later as dad declined, they visited him in hospital to re assess his needs,” “Yeah, both, everything from washing, cleaning cooking and a mental assessment. It was in depth with me and mum” and “Yes the experience was good, they also regularly update care plan and involve me in this.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. In most cases relatives arranged health and social care appointments for their loved ones but the registered manager told us that staff would step in and help make these arrangements if needed to ensure that people received the support they needed. People and relatives confirmed this telling us that staff would always step in to help if there was a need. Staff told us that they worked well alongside partners who could provide specialist support. A staff member told us, “Any changes I would update notes and tell line manager. A client I support could not move so easily so I got the occupational therapist (OT) to come out and they now have a hoist. The managers had seen this in my notes.” Care plans clearly described people’s needs and preferences and the level and type of support they required. Details of other important professional contacts were clearly highlighted as were records of previous appointments.

The provider worked well across 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. Care plans were clear and accessible to staff. Staff knew people well and knew their support needs and how people preferred to be supported. Staff liaised with other professionals to ensure people received the support they needed quickly. The registered manager told us that they worked closely with the local GP’s district nurses and occupational therapists and were able to provide clear communications so that any immediate needs could be addressed. Some professionals visited people regularly for example, district nurses who supported people with catheter care. People had a regular routine of support to meet their needs.

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. Some people were supported by staff to meet their hydration and nutrition needs. Staff were aware of people’s likes, dislikes and allergies and prepared food for them accordingly always providing choices. A staff member said, “Give people choice. Often a ready meal but usually have two or three to offer.” Another staff member told us that some people preferred to eat alone so they would prepare food towards the end of their care call to allow this. Care plans reflected any dietary requirements and covered in detail people who were living with diabetes. Risk assessments were in place with clear instructions to staff about which foods to offer and which to avoid. Staff were aware of the steps to take in the event of a diabetic incident. Any cultural or religious dietary needs were also highlighted in care plans.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Staff knew people well and told us they could tell if something was wrong or if there were changes in support needed. Staff recorded their tasks and visit notes on their mobile phones and this was monitored by managers remotely. Any changes were highlighted so that action could be taken if needed. For example, if people were eating less or were less mobile than they had been, these issues were highlighted and relevant partners called in for example, speech and language therapists (SALT) and occupational therapists. This close monitoring of people led to quick interventions and better outcomes for people.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People’s capacity to make decisions was discussed with them and their loved ones. This was recorded and referred to when reviewed to establish if there had been any changes in their decision making ability. A relative told us, “Yeah, dad makes own decisions about care, he may forget but he does make his own mind up. He still has mental capacity. We are not quite there, I did meet with the home recently as dad didn’t want them to do personal care but this has been resolved.” The registered manager told us they were confident with decisions about people’s capacity to make decisions and that the mechanism was in place to assess individual decisions if needed. They told us about the importance of having meetings to make sure decisions were made in people’s best interests but also understood that people with capacity sometimes made poor decisions but these needed to be respected and safely managed. Staff had received training in mental capacity and knew the importance of gaining consent from people. A staff member said, “Also done dementia training. I always ask people about things, give them a choice. Like food, can take different things out of fridge and they can chose.” Another added, “Can ask their relations for support. If they say no I’ll try and explain but would never force anyone.” Care plans highlighted if people were living with dementia but emphasised that they were able still to make specific decisions relating to their care and support at that time.