Homescare Ltd - Peacehaven

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

A pre-assessment process was in place carried out by senior staff however some relatives told us they had not been involved in the assessment process. People’s health and social care needs were met by the service who worked with other statutory partners to achieve the best outcomes for people. People had access to the services they needed. People’s nutrition and hydration needs were met by a team of cooks that knew people well and were aware of people’s allergies, likes and dislikes. Staff knew people well and knew about the importance of gaining consent from people before carrying out any task or activity. Not all mental capacity assessment pre-admissions had been completed and the registered manager was receiving support from the local authority to achieve this.

This service scored 62 (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 relative’s experience of the pre-assessment process varied. Some told us they were involved in the process and attended pre-assessment meetings. For example, a relative told us, “Yeah, we were involved, it all happened very quick due to dad being in another home. We worked with the Local Authority (LA) to get funding. The process was good once we found this home.” Other relatives however told us of a different experience. They said, “I wasn’t involved in any pre-assessment meeting for this home.” Similarly, most relatives said they had not been invited to or involved in any ongoing reviews of people’s care and support needs. A relative said, “I wouldn’t say we have had a review, as I’m there every day we just discuss changes.”

The registered manager or deputy were responsible for pre-assessments and the information recorded fed into people’s care plans. Staff told us that they had received training in assessing people’s needs so that if over time a person required more or different care and support, they were able to identify this and report to managers. A staff member said, “We are trained to assess needs and we know what to do with falls. Some are very likely to have a fall.”

Care plans and risk assessments were in the process of being reviewed and updated. New pre-assessment documents formed part of care plans and this included any known identified risks. However, some care plans did lack detail. The registered manager was aware of this and was taking steps to update the plans.

People and their loved ones told us that their needs were met at the service. If people needed support from other professionals then the service would help. Relatives told us, “Yeah, they do – they arrange doctors and eye tests/appointments,” and “They will let me know what mum needs and I book the appointments.” People also told us that their nutrition and hydration needs were met and that staff took time to make sure they gave them options each mealtime that were appropriate to their needs.

The registered manager and wider staffing team all reported positive working relationships with other agencies and professionals. There were no issues or concerns with contacting for example, GP’s, district nurse or dentists when needed.

Most care plans had details of important contacts for people. These included relatives or advocates, GP’s and other specialist professionals to contact if and when needed.

A relative told us that their loved one needed hospital treatment following a fall at the service. They described a smooth process where 111 were called. Paramedics attended, assessed and then took the person to hospital for a fuller assessment. The relative described the process as smooth with teams working together quickly to ensure the best outcome for the person.

Staff told us how they sought advice from district nurses regarding wound care and catheter management and also from speech and language teams for advice about people’s diets. Staff said that they all worked together in people’s best interests.

The local authority had been supporting the registered manager and told us that working together, progress was being made with various systems and processes and the development of care plans and risk assessments. Communication had improved and the service were actively engaging with the progress being made.

Information exchange between services was positive, although we requested information sharing agreement documents from the registered manager and these have not been produced. Not all information provided by health professionals was recorded in care plans. For example, no catheter care plans were in place.

People told us that the food at the service was nice, that they had choice and that they could request drinks and snacks in-between main meals. Relatives told us they were happy with the food provided and that the kitchen staff knew about people’s particular needs for example, people living with diabetes. A relative said, “There are choices – they are asked every evening what they want for tea/lunch – hot and cold options.”

The chef was knowledgeable about people and their dietary needs. They told us there were a team of cooks that covered 7 days a week and each day they would speak with people and talk through their options for meals for the day. The menu always contained fresh seasonal food.

The kitchen was clean and well equipped. Required daily temperature checks had been completed and the latest food hygiene rating was displayed. People’s regular appointments with other professionals were diarised and managed by the service.

People and relatives’ experience of reviews of ongoing care and support were varied. Most told us they had not been involved in formal reviews in the past 12 months. However, they did tell us that they were confident to raise any issues or concerns at any time. A relative said, “I wouldn’t say we have had a review, as I’m there every day we just discuss changes daily.”

People’s care needs were being reviewed by the registered manager as part of their wider care plan review. The registered manager was aware of the need to involve relatives or advocates in the review process.

Day to day monitoring took place and staff were kept informed of accidents, incidents or any changes in people’s care and support needs through the shift handover meetings. More formal auditing processes to manage positive outcomes for people was a work in progress being developed by the registered manager. These auditing processes needed time to embed.

Some people living at the service had full capacity and others needed support with some decision making. A person said to us, “They ask if I’m ready, I do choose. I like to go to bed a bit later than some.” Relatives of people that required support told us that staff were kind and took time with people, asking for and explaining consent before carrying out any task or activity.

Staff knew people well and were aware of the importance of consent. They knew how best to support people with day to day decisions such as what food to choose or what clothes to wear each day. The registered manager was aware that not all mental capacity assessments had been completed and was receiving support from the local authority in completing these.

Mental capacity assessments were out of date and not always decision specific. This was being addressed as a priority by the registered manager but needed time to be completed and then to embed into staff knowledge. Similarly, not all Deprivation of Liberty Safeguards (DoLS) had been applied for and the service was receiving support with best interest decision meetings. These processes needed time to fully embed.