Generations Care Ltd

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 of this key question in 2019 we rated this key question as good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed 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.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People and relatives told us they were involved in deciding what care was required to meet their needs and preferences. A relative said, “We requested one carer [who spoke a specific language] because [person] cannot communicate otherwise, and they have been really good with that. They send regular carers and now understand from certain movements [person] makes, it’s comforting and reassuring.” Staff told us people’s assessed needs were completed before they started to deliver care. The views of people receiving care and their family members had been taken in to account when assessments were carried out. Processes were in place to keep staff up to date with any changes to people’s needs.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Processes to deliver evidenced based care included medicines administration records and daily monitoring records to ensure people’s needs continued to be met. However, inconsistent records completed by staff did not always show people received care in line with their assessed needs. For example, people with modified diets and those who required medicines to be administered in a particular way. The registered manager agreed to improve their processes to ensure accurate recording was completed. People felt the care they received was what was agreed. One relative said, “They come to do a review every now and again to make sure they’re doing everything [person] needs. They’ve discussed things with us and made changes.” Staff told us they followed people’s care plans, giving people choice of what they wanted to eat and drink. Staff told us they followed best practice guidance, for example when people required thickened fluids. However, we found that although guidance was in place, it was not always followed.

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. People described good communication between staff and other healthcare professionals involved in their care. Relatives felt staff communicated effectively with them and shared any changes to people’s needs. Staff knew what action to take to support people when they required help from health professionals for advice, support or guidance. Staff said they worked well with health professionals and the outcome of any visits was communicated to them via their coordinator. Professionals shared how the management team promoted communication to ensure effective sharing of information. One professional said, “I personally think from my perspective, on the whole, Generations are great to work with. Carers really do promote patient goals to work to independence and if there is an issue, [staff] respond quickly and effectively with the therapy team to problem solve and find the solution.” Care records listed professionals involved in people’s care so staff could contact them promptly for advice as needed. There were regular team meetings where managers shared information and guidance.

The provider supported people to manage their health and wellbeing, so people could always maximise their independence, choice and control. People’s relatives confirmed staff supported people as much as possible to manage their own health and wellbeing. Staff gave examples of how they supported people to live healthier lives for example offering and encouraging low sugar diets to people with diabetes. Staff said they made referrals to other healthcare professionals to promote people’s safety.

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 that they met both clinical expectations and the expectations of people themselves. Some processes were not always effective to make sure clinical tasks were completed and recorded regularly. For example, when staff supported a person experiencing a seizure and when people required support with modified diets. However, some care plans reflected people’s needs and the outcomes they wished to achieve. For example, one person wanted to regain their independence by being supported to regain their daily living skills. Despite our findings people and relatives were positive about the support provided. One relative told us, “I feel nothing needs improving, we are happy.” Staff had a good understanding of people’s individual health needs and knew the importance of monitoring people’s health conditions; however, outcomes were not consistently recorded.

Care records informed staff if people had capacity to make day to day decisions and when a power of attorney (POA) had been appointed. However, if it was believed a person did not have capacity to make a specific decision or had fluctuating capacity, mental capacity assessments were not always completed. There were no records to show best interest decisions had been considered and completed in line with the legislative requirements of the Mental Capacity Act 2005. Despite this, people did not raise any concerns about a lack of choice or feeling compelled to do anything they did not want to do. People and their relatives confirmed staff sought people’s consent before providing care and support. A relative told us, “If [person] doesn’t want to go in their chair, they respect their choice.” Another relative said, “Staff always say what they are going to help with because half the time [person] doesn’t know why they are here, they will always say we are going to help you have a wash.” Staff told us they sought people’s consent when providing care and support. They also shared examples of how they worked in people’s best interests when a person did not have capacity.