Supreme Care Services Limited

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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

We assessed 2 quality statements in the effective key question and found areas of good practice. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Our rating for the key question remains good. We found that people were involved in their care and their consent to receive care was sought by staff and the management team. Where people could not consent to care, the appropriate legislative processes had been followed. People had their needs assessed thoroughly before care commenced and were involved in how their care would be delivered. People told us care was consistent and they were asked for their consent before care began or changes were made to their care.

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.

The registered manager described the process for assessing people who require support from the service. They told us “Assessments for new referrals are completed within 48 hours, in this time the person has a copy, and the carer has a chance to read the plan and are encouraged to ask questions and we ensure that appropriate training has been done. We ask service users if they have preferences on carers.” If care is provided in an emergency without time for an assessment, the registered manager told us, “We step in to make sure they are safe and then do the assessment. We ask social services for the care plan and discharge summary; the first visit will be a carer and a supervisor.” The registered manager told us that the service responded to changes in need by updating the assessment and care records. They told us “If there is a change in need, we do a re-assessment of the care plan and send a copy to social services and we update the person and their next of kin.”

People told us that they had consistent carers and were always involved in the care that they were receiving. Relatives told us that they were involved in any assessments that their relative needed and what they wanted often discussing as a group to ensure the person receiving care was also involved. One person told us “I knew from the initial assessment that the service had a strong management team.”

The assessment of peoples needs captured personal history and preferences. People had contributed to their assessments and where people had a representative to help them with making decisions, they were also included in the assessment. Detailed assessments had also been carried out with respect to specific needs such as how to help someone mobilise using equipment.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

People told us that staff were mindful of their preferences, how they liked things to be done and that they always ask consent before going ahead with a task. One person told us “I am so close to my carer, they know everything about me but they always ask permission regardless of how well they know me.” A relative told us “I work in another room and the carer is here all day and they will come in to the room to advise me if they are going to give pain killers, if they think that my relative is looking tired they will ask if it is okay to put them into bed.”

Staff told us that they were guided by people and what they were happy for staff to do. Staff were conscientious about keeping people informed and involved in their care, particularly people with dementia who may be unable to give consent. Staff told us how they support people to maximise their capacity to consent, one staff member said, “I explain as many times as is needed to reassure the client and help them to understand”. The registered manager told us that if there is doubt about a persons capacity to independently consent to care, they follow a process to establish how they can be supported. They told us that if a person is unable to consent “we ask their next of kin if they have [legal representation], if not we ask for an advocate and we will then have a best interest meeting. We always ask the local authority for capacity status before taking on a care package.” Where someone does not consent to care and there is a risk to their safety, the service informs relevant professionals to manage the risk. The registered manager told us, “If medication is refused or we do not get consent from the service user, we involve the next of kin and GP and make the local authority aware of this.”

We saw that peoples care plans clearly state whether the person can make decisions about their care independently. Where it is suspected people do not have the mental capacity to make decisions, this is assessed. We saw that people’s consent to receive care is always documented and where people had a legal representative supporting with decision making, this was also clearly recorded.