Right at Home Camden, Hampstead & Golders Green

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

The service assessed and reviewed people’s care and support needs with them. People’s care and risk management plans were personalised and focused on empowering people to be independent. Leaders checked the service was meeting people’s needs. Staff supported people to eat and drink enough and respected people's preferences. The service worked in partnership with other professionals to meet people’s health and social care needs. Staff supported people to make informed decisions about their daily living and respected their choices and the service worked in line with the Mental Capacity Act 2005.

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.

People and relatives told us they were involved in assessing people’s care needs and planning how they wanted these to be met. For example, a relative said, “I have been involved with my [family member’s] care planning and am still involved.”

Staff contributed to reviewing and updating assessments of people’s needs. A care worker told us, “If there’s anything new, I let them know and they add it to the [care plan].” Staff felt listened to and involved in this. Staff explained their approach to conducting people’s assessments in a personable, sensitive manner, adding “I want to listen to them, I don’t want to tick boxes in front of them. I want to engage with them, hear what they want, [understand] their personalities.” This helped ensure assessments involved people meaningfully and were person-centred.

There were effective processes in place to assess and review people’s needs. Assessments considered people’s health, care, wellbeing, and communication needs, to enable them to receive care or treatment that has the best possible outcomes. The assessments and reviews of people’s needs informed their care plans. This meant people’s plans were up to date and reflected their choices about their care needs and how they wanted to be supported. Staff completed additional training based on a person’s particular nutritional support needs so they understood how this affected a person and how to support them with this. For example, when a person used a tube surgically placed in their stomach of a person to help with feeding when they cannot eat or swallow food safely.

People and relatives felt the care and support met people’s needs in the ways wanted. People commented, “I cannot praise [the care worker] enough for what they do” and “We have a wonderful carer.” Staff supported people to prepare meals or assisted people to eat and drink as they wanted when this was part of their agreed care. This respected their choices and preferences. A relative said, “The carer will make them everything they like to eat.”

Staff demonstrated a good understanding of using person-centred approaches to support people living with dementia. For example, using compassion and low arousal techniques to support people experiencing anxiety or distress. Staff helped people use equipment such as dementia clocks to maintain important daily routines and promote their independence. Staff described how they ensured people’s meals were in line with their religious and cultural preferences and medical needs. This included how to prepare and store certain foodstuffs.

People’s care plans described how to support a person living with dementia in line with good practice. For example, with detailed, pre-emptive and comforting approaches to support a person who experienced anxiety and confusion. Staff had attended dementia care awareness training to inform their practice. Care plans set out people’s food and drink likes, dislikes and preferences in good detail and promoted their nutrition and hydration support. For example, a person’s plan described the specific mealtime choices and routines that were important to them. Another person’s plan noted staff were to support them with special sweets to encourage them to keep hydrated. Staff were encouraged to promote people hydration. Staff maintained daily care records of people's daily food and drink intake and how staff respected people's choices and preferences. People’s plans were clear when a person required food and drink modified to certain consistencies and support to eat safely, for instance due to a risk of choking. These plans were informed by speech and language therapist recommendations and the International Dysphagia Standardisation Initiative’ (IDDIS) framework for food preparation.

People and their relatives were supported by staff who worked in partnership with them and other services to provide effective care.

Staff worked with other professionals to help them meet people’s needs in a person-centred way and staff gave examples of this. The registered manager was proactive in engaging with other services to support people, such as seeking referrals from GPs for additional healthcare support or assessments for a person. Staff told us they always had access to good information in people’s care plans about their care needs and preferences.

Professionals we spoke with said the service worked with them in an effective, coordinated manner. Professionals told us, “They do understand the needs of [the person] and where [a healthcare professional] can fit in” and “I find them a caring and personable team.” They found the registered manager was always well-informed about people’s needs and preferences. The service shared information appropriately to promote continuity of care and help ensure people’s needs were met.

The services systems and processes facilitated co-ordinated care and collaborative approach with other services. For example, by maintaining and reviewing care plans, incidents records and daily care notes the registered manager was always informed about people’s situations. This helped them liaise with other health and social care professionals and advocate for people’s needs. The digital care planning and daily notes systems meant all relevant staff could see up to date information about a person’s health and wellbeing.

Staff supported people to meet their healthcare needs and helped them liaise with healthcare professionals, such as GPs, occupational therapists and pharmacists. Staff helped people to arrange and attend health appointments when required. We saw the service had received compliments from relatives for the healthcare support staff provided.

Staff monitored people’s healthcare needs, for example a person’s skin integrity or if they showed signs of becoming unwell due to a condition such as diabetes or Parkinson’s. A staff member described how they discussed health concerns with a person in a sensitive, understanding manner to help them overcome a reluctance to accept help. The person then attended healthcare assessments which led to a change in their prescribed medicines and an improvement to the health. Staff helped people to be more active which contributed to improving their health and independence.

People's care plans set out their medical history, an assessment of their health needs and the support they required with to meet these. This included oral health care support. Staff completed oral health care training. Staff had access to relevant guidance and support about people’s health needs to help inform and support their practice. They completed additional training based on a person’s particular health condition so they understood how this affected a person and how to support them with this. For example, when a person used a catheter or lived with diabetes. Service records showed staff supported people to attend health appointments where needed. Daily reporting by care staff meant the office team and registered manager could monitor people’s wellbeing and identify any health deteriorations.

People's care and their needs were monitored consistently to ensure they always experienced positive outcomes that promoted their wellbeing. A person told us, “They come occasionally from the office to check things are ok.” People and relatives had no concerns about people’s care, felt well supported and all spoke about the care experience in very complimentary terms. People said, “They do everything I need them to do” and “We are very happy with Right at Home and with the care they have provided.” People’s care plans tool into account their strengths and skills and the things that were important to them.

Staff we spoke with demonstrated a good understanding of people’s needs and how to meet them. The information in people’s care plans, including details about a person’s history, likes and preferences, helped staff to do this. Care staff, the office team and the service leaders were committed and motivated to supporting people to achieve good outcomes. Care staff were encouraged to ‘go the extra mile’ by identifying extra things they could support people with. The director had recently appointed a member of staff to lead on and develop this initiative.

There were effective approaches to monitor people’s care and their outcomes. Care staff maintained detailed records of the care they provided and any reports of concerns about people’s wellbeing or changing needs were reviewed on a daily basis. Care plans were reviewed regularly and when people’s needs changed. People were routinely asked if they were happy with the service. Senior staff periodically visited and checked that staff were supporting people effectively. The registered manager regularly reviewed these service systems, as well as staff training and supervision, to inform their ongoing monitoring of the service. They used this to make continuous improvements to the service to ensure people’s needs were met. For example, making sure assessments and care plans clearly identify the outcomes people want to achieve.

People and relatives told us their views and wishes were listened to both when staff provided care and when the service planned their care with them.

The staff and registered manager worked in line with the principles of the Mental Capacity Act (MCA) 2005. Staff and the registered manager understood the importance of gaining people’s consent to their care and respecting people’s right to make choices about their daily living. Staff completed training on understanding mental capacity and the MCA.

The service was working in line with the principles of the MCA . There were procedures in place for assessing people’s mental capacity to agree to their care or make other specific decisions when needed, including working with people’s relatives to do this. Regular audits of care and risk management plans included checking people’s capacity and consent arrangements. This helped the provider to make sure people’s rights were protected in line with the MCA.