Sure Care Chester

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 changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Although processes were in place to ensure staff understood and managed people’s needs and peoples’ care records evidenced their individual needs had been assessed, we were not assured people’s needs were always being met. Some people fed back that care calls had been missed, this had meant people’s needs had not been met, for example, some people had not received a shower and some people had not been assisted to go to bed. One person told us, “I don’t feel I get person centred care.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

We were not assured people’s identified needs were being met and the provider planned and delivered people’s care and treatment with their involvement. One person’s relative told us how he had turned staff away as they had arrived too late for the person’s call. The lack of care which should have been carried out by staff, meant the person was at risk of harm due to a pre-existing health condition.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The provider did not always work effectively to deliver effective care and support to maximise their independence, choice and control. Care and support were not always properly planned and coordinated. Some people’s care calls had been cancelled with little or no notice. This did not demonstrate staff teams working together effectively to meet people’s needs.

However, we did see some evidence of practices taking place to support people who required any help and guidance with referrals to external healthcare professionals when needed. The manager was able to describe when referrals were needed to other healthcare providers such as district nurses, to enable people to remain independent while living in their own home. A member of staff confirmed, “I noticed a person was having some difficulty swallowing and so we got SALT (Speech and Language Therapy) involved.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

We were not always assured people experienced positive outcomes regarding their health and social care needs, as some care calls were either missed/significantly later than planned or not for the required call duration. This did not ensure people had genuine choice and control over their health care needs.

However, the manager was able to explain how they would support seeking external assistance for people who needed it, for example, recognising when a person may need to see a GP. They also explained how they supported a person to attend the swimming baths to help promote a healthier life.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or they met both clinical expectations and the expectations of people themselves.

Whilst some processes were in place to ensure peoples outcomes were monitored, we could not be fully assured care and support reflected current evidence-based guidance standards and best practice. People had not always received their care calls, and some had received them later than planned. For example, 1 person received their care call significantly later than planned, meaning they were assisted to bed much later than they preferred.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

People had signed paper copies of their care plans; however, we did note a team leader had signed an electronic copy of their plans, when it was not necessary. We spoke with a team leader about this.

We were not assured people’s rights around their care and support had been respected. Some people had not received the care and support they required.

People told us staff asked them for their consent before delivering care and support. One person told us, “Staff ask me if it’s OK.”