South Norfolk Carers Limited

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 inspection we rated this key question requires improvement. At this inspection, the rating has changed to inadequate. This meant there were widespread and significant shortfalls in people’s care, support, and outcomes. The service was in breach of legal regulation in relation to consent and person-centred care.

This service scored 29 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing, and communication needs with them. The service had failed to holistically assess people’s full needs in relation to their health, personal care, communication, emotional, social, cultural, religious, and spiritual needs. The people we spoke with gave examples of where their needs had not been met and the impact this had on them. Staff agreed that the lack of information on people’s full needs and preferences contributed to people receiving ineffective care that did not meet all their needs. The records we viewed confirmed people’s feedback and showed us that the service had failed to effectively and robustly assess people’s needs to ensure their care was consistently effective.

The service did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards. We found many examples of where the service had failed to adhere to best practice guidance and standards meaning people’s experience of the service was below what was expected. The people who used the service told us this and the impact it had on them. We saw that whilst some nationally recognised assessment tools were in place, these had not been used appropriately to assess and monitor people’s needs and risks. Furthermore, people told us that despite them raising concerns or requesting amendments to their care, these had not been acted upon by the service.

The service did not always work well across teams to support people. Some people’s care was delivered by numerous staff and they did not have a consistently dedicated small group of staff delivering their care. This meant staff often supported them without understanding their needs, risks, or routines; people told us this. Staff agreed, with one staff member telling us, ‘We go in blind a lot; we aren't told what we need to do for people.’ Staff also told us communication from the management team was poor meaning they were not always updated on people’s changing needs which placed people at risk. Our assessment findings showed where people received care from a small, dedicated staff team, they received continuity of care. However, many people we spoke with told us this was not the case and their care was delivered by multiple staff who did not fully understand their needs, routines, or preferences. Furthermore, the service could not consistently demonstrate referrals had been made to health and social care professionals as required.

The service did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice, and control. The service did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. People told us that sometimes the service had a negative impact on their health and wellbeing because care call times were not flexible enough to allow them to attend health appointments. One relative gave us an example of this and said, ‘I wish the service could be more supportive and arrange visits that work around appointments.’ The records we viewed could not always demonstrate the service had called health or social care professionals as required. Whilst the registered manager told us referrals had been made, the records did not always confirm this.

Whilst the service mostly monitored people’s care and treatment routinely, they failed to act when concerns were raised to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met the expectations of people themselves. People’s experiences of using the service told us they did not all result in a consistently positive outcome or that it met their expectations. This was because people were not consistently receiving care from people who knew them and their needs, had inconsistent care calls that caused them anxiety or because they did not feel listened to when they raised concerns. From the records we viewed, we saw that most people’s care was regularly reviewed. However, we identified instances where people had raised concerns about the care they received where the service could not demonstrate what action they had taken in response to improve the outcomes for those people.

The service had not consistently sought and recorded people’s legal consent to care and treatment. Whilst the people we spoke with told us staff sought their consent at the point of care delivery, we saw that formal consent was not always in place or provided legally. For example, for one person, consent was not in place and it was unclear whether consent had been given verbally but that the person was unable to sign consent, or whether consent had not been given at all. For another person, the service had failed to ensure the person who had given consent to care had the capacity to do so. Despite the provider having procedures in place for gaining people’s consent to care, these had not been followed.