Pacific Care Services Limited - Isle of Wight

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. Care plans were generally tailored to individual needs and preferences, and staff described adapting care based on what people wanted.

People told us they were asked about their wishes when care started and that reviews took place. A person said, “They [office staff] came and asked what I wanted and did a care plan and they have been back to review it.” Staff confirmed they used care plans and asked people how they liked things to be done. A staff member told us, “People are different and not the same so are not cared for the same. The care plans are all person-centred, so the care is also person-centred.” Another said, “I always ask how they like things to be done.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. The service could respond quickly to changes in people’s needs, such as following hospital discharge or when extra visits were required. Office staff described flexibility in increasing care packages temporarily while awaiting funding approval, which avoided delays in care needs being met.

However, continuity of care staff was inconsistent. People experienced variable continuity of care. Some reported seeing the same care staff regularly, while others had different staff and inconsistent call times. Records confirmed this inconsistency. Family members expressed frustration about frequent changes without notice, which they told us made planning difficult.

We received mixed feedback from people and family members. A person said, “I have had them [Pacific care] over a year now and I’ve got the care plan here… they are very good at changing things, very flexible.” However, another told us, “We would like to have regular staff again, we would be happier with that and so would [relative].” External professionals described good communication with office staff but raised concerns that care staff were not always fully briefed on client needs.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s communication needs were identified during assessments, and care records included relevant details. Staff were aware of data protection and confidentiality requirements. Complaints information was available in people’s homes, and most people felt they could raise concerns.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support, however, systems for complaints were not always followed. The provider had a complaints procedure, but a staff member told us complaints were sometimes handled verbally rather than documented. This could lead to disputes about whether concerns were raised and limits the ability to monitor trends and improvements.

People and families told us they felt listened to when they raised concerns and that issues were usually resolved quickly. A person said, “If I have any issues I just say and they [staff] deal with it quickly.” Office staff confirmed they visited people for care reviews and field supervisions with staff, providing opportunities for feedback.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Out-of-hours communication was a recurring issue, with calls diverted to a mainland office where responses were described as abrupt or unhelpful. This meant people and families did not always receive timely or supportive responses outside normal office hours. A family member said, “At weekends it’s an answer machine that just says, ‘We are closed until Monday.” Staff also reported delays when contacting on-call and described feeling stressed when urgent changes were needed.

The management team understood how to access specialist health or social care support or equipment when required. Care staff had undertaken equality and diversity training, and people did not report any concerns about discrimination. People with different needs, including adults with mental health conditions or learning disabilities, were supported to access activities of their choosing. However, there was limited evidence of structured planning for goals and aspirations, which could help promote equity in outcomes. They were confident office staff would take appropriate action but were less confident about getting a good response when contacting out of hours on call.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Care staff had completed equality and diversity training, and people and family members did not identify concerns about discrimination. Feedback indicated people were treated with respect and dignity.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future.

The service could provide end-of-life care and had links with specialist services such as the local hospice and community nurses. Information about the level of care people should receive in emergency situations (resuscitation) was included in care plans and on emergency information ‘grab and go’ sheets in people’s homes. A staff member said, “We have access to equipment and input from partners for good end-of-life care.”

Pacific Care also supported adults living with a mental health need or a learning disability. Although information showed they were supported to access activities of their choosing, there was limited information about identifying goals and aspirations that could be worked towards. This was discussed with office staff who agreed to further consider this.