DBAGZ SOLUTIONS LTD - BRIGHTON

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• 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

People received effective support. Peoples’ needs, and choices, were assessed and took into account people's diverse needs and preferences and were supported to live healthier lives. Staff could support people to access healthcare services if required and those who required support with eating and drinking reported they were given choice and control over what they wanted to eat and drink. People were supported in accordance with the Mental Capacity Act. Staff demonstrated an understanding of the need for consent and supporting people to make decisions about their care. Staff worked with other agencies and partners to ensure timely and effective care. Professional feedback we received was positive about how staff delivered care and their responsive to partnership working.

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.

Each person had a full and completed initial assessment in place, which people confirmed that they, and their relatives, were involved in. Each assessment included a review of their capacity and ability to communicate their needs and wishes. There was detailed information taken from people on how they express these wishes. One person said, “They came in asked me questions, asked me what I needed and what they could offer. We agreed upon something.” Peoples’ needs, and choices, were assessed and took account of preferences for their support. Protected characteristics and diverse needs under the Equality Act formed part of this process. For example, people’s religious needs and preferences were captured. The needs of carers were addressed by the provider. A comprehensive Lone working policy was in place to support staff needs and ensure they could provide safe and effective care. The registered manager described a thorough review of the information they received from partners and professionals when they commenced a new package of care. The provider undertook a current assessment, as information they received did not always fully reflect the person's current level of need.

People received care, treatment and support that was evidence-based and in line with good practice standards. Each person had a full and completed initial assessment in place, an assessment that they confirmed involvement in. Staff monitored peoples care and support needs using good practice tools, such as monitoring charts, nutrition and hydration tools as well as evidence-based guidance such as Bristol stool charts to monitor one person's bowel care. People who were identified as being at risk of skin integrity breakdown were monitored with repositioning charts so that staff could reduce the risk of skin breakdown.

Staff had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support. The registered manager said, "We upload care plans and pass info to staff. They evolve as the package goes on. When families communicate with us, we make sure it is communicated with staff. We also use an (electronic application group chat) as well as the electronic system. We will put cancellations on the group chat and follow up with a phone call.” An electronic care system was in place with carers using electronic applications on their phones to access up to date information about people's needs. We saw a demonstration of the application by the registered manager, showing the information that carers could access. The registered manager said, “We can grant family access to allow families to know what carers are doing, with people’s permission. They have access to care notes, care plans, medication, nutrition. It keeps everything transparent.” Professionals and partners in care said that the management and staff were effective in information sharing and partnership working. Appropriate and timely referrals were made when needed. One professional who worked with the service said, “In my opinion, the care agency was very efficient in referring to social work and occupational therapy services to ensure that the care calls were meeting the customer's needs.”

People were supported to manage their own health, care and wellbeing needs by staff who understood their needs and preferences. Some people were supported by care workers to prepare food and meals. People told us that care workers prepared meals that they had chosen and was done effectively. Some people had been identified as being at risk of dehydration. People said that carers were diligent in providing, and leaving, drinks for them. Where risks had been identified, carers monitored and recorded the input and output of fluids effectively. When needed, carers used assessment and monitoring tools, such as the Bristol stool chart, to monitor one person’s bowel care. Oral health assessments had been completed for some people to ensure that they could be supported to maintain good oral health. Appropriate referrals had been made to specialist services when additional health support was identified as being needed.

People experienced positive outcomes to the care they received. The monitoring of people’s care and health needs used evidence-based guidance and tools to monitor outcomes effectively such as Bristol stool charts, hydration recording sheets, repositioning recording sheets for example. The provider was proactive with communication with, and timely referrals to, external professionals and stakeholders to ensure that outcomes remained positive for the people they supported. Feedback from stakeholders was positive in ensuring continuous monitoring of people’s support.

People were supported in accordance with the Mental Capacity Act. Each care plan included an assessment and review of people’s capacity and ability to communicate their needs and wishes. There was detailed information and guidance on how people expressed those wishes. People confirmed that their views and wishes are taken into account when their care is planned. People and their relatives told us staff sought consent before providing care. One person said, “They always ask me for permission and ask what I want.” Another person said, “They ask permission and then tell him what they are going to do.” Staff receive training on the Mental Capacity Act and understood their responsibilities regarding MCA, and the importance of people being involved and making their own decisions.