HLC Care Agency 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

People’s needs were not robustly assessed before they started receiving care from this service. There was not an effective system in place to continually review and assess people's health needs and ensure care and support plans reflected people’s current needs. People’s care plans and daily notes were not person centred. People’s capacity to consent to their care had not been robustly assessed. The staff and the registered manager did not work effectively across teams and services to support people. For example, staff and the registered manager had not ensured they provided co-ordinated and joined up care with other services. The registered manager did not deliver people’s care in line with evidenced-based good practice, including what is important and matters to them. We found one breach of the legal regulation in relation to person centred care.

This service scored 33 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

While the people we spoke to expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. People could not be assured their needs had been appropriately assessed and understood by staff. People had not been involved in a meaningful review of their support, and their views and preferences had not been acknowledged. People's care plans and daily logs were not person centred, and did not put people at the centre of their care.

The registered manager told us that the care plans were ‘up to date’, however we know this was not the case as care plans contained information that was not reflective of people’s current needs. The registered manager had not carried out regular reviews of people’s care plans or carried out thorough assessments of people’s health and support needs. For example, one persons care plan detailed they needed support with pain patches, however the registered manager then found out this had stopped 3 years ago and they were unaware it had stopped.

A comprehensive and holistic assessment of people’s need had not been completed. There were no effective systems in place to assess and review people’s health, care, well-being and communication needs with them, to ensure care plans were reflective of people’s current needs. One persons’ care plan contained contradictory information around their communication. One document detailed the person did not have any support needs regarding communication, however another document detailed that staff needed to communicate in a certain to ensure the person could understand.

While the people we spoke to expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. For example, people did not receive care that was in line with good practice.

The registered manager told us the support plans were ‘good’. However, we found this to not be the case. We identified a number of areas of concerns. Staff and the registered manager did not have a good understanding of people’s health needs and how best to support them. For example, this included a lack of detail around epilepsy care plans.

The registered manager had failed to ensure processes were in place to deliver care that was in line with good practice. For example, the registered manager had not considered the NICE guidance around epilepsy and how best to support someone who lived with epilepsy. One person’s epilepsy care plan contained little information to guide staff on how to support them. The care plan also did not contain any information from the relevant supporting health professionals regarding the persons epilepsy. The provider’s systems did not ensure that staff were up-to-date with national legislation, evidence-based good practice and required standards. For example, staff had not received practical training around on how to support people with their mobility needs.

While the people we spoke to expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. For example, the registered manager and staff did not work effectively with other services to ensure care for people was co-ordinated.

The registered manager was unable to tell us what other services or support people had in place. For example, one person’s care plan detailed they had a personal assistant, however the registered manager told us they didn’t know who this was or have any contact details for them. Staff we spoke to also did not know what other support services the person received.

The registered manager and staff did not work effectively across teams and services to support people. Staff did not have access to the information they needed to appropriately assess, plan and deliver people’s care and support. For example, care plans did not contain information about other support people had, such as personal assistants or other carers from different providers. The registered manager had not ensured people had continuity of care or worked collaboratively with other services, they did not share information between teams and services, which left people at risk of not having their needs met

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.

While the people we spoke to expressed that they were generally happy with their care, our assessment found care did not meet the expected standards. For example, people’s capacity to their care and treatment was not always effectively assessed. People could not be assured their views and wishes were sought or acted on: people were supported by staff who lacked understanding about people's rights.

Staff we spoke with were not always sure about people’s capacity to consent to their care and treatment as there was a lack of information in people's care plans. For example, one staff member told us ‘To my knowledge they can make all decisions themselves’. However, information about capacity in the care plan was not detailed to ensure staff fully understood how to support people to make choices. When we asked the registered manager about people’s capacity, they told us the person had capacity and was unable to provide further information regarding any processes that they had in place.

Processes were not robust when assessing people’s capacity. There was no evidence that systems were in place to ensure people’s views and wishes were taken into account. It was not always clear in people’s care and support plans what support they needed regarding their capacity. For example, one person’s capacity detailed they have anxiety but it failed to detail what implication this had on the person’s capacity, if any, and how staff should support the person making decisions if and when they are anxious.