Virtuous Business Solutions Limited

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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.

This is the first assessment for this service. This key question has been rated Good. This meant people’s needs were met through good organisation and delivery

This service scored 71 (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.

Where people required support to manage their emotions, care plans contained detailed, personalised guidance for staff, including information about what mattered to the person, known triggers, early warning signs and the actions staff should take to provide appropriate support.

Care records were detailed, personalised and informative. Staff documented clear accounts of each visit, including the support provided and any relevant observations. For double-handed visits, both care staff contributed to the records, helping to ensure a comprehensive and accurate account of care delivered.

Professionals spoke positively about the provider's person-centred approach. One professional described the service as, "Aware of risk, however client-centred and willing to see and understand people and their needs on their own merit. They achieve less restrictive outcomes than other services and are client centred."

There were some shortfalls in how the provider organised and delivered people's care.

People did not always receive care at the times specified in their care plans. People and relatives told us, staff were sometimes late to visits.

Although people understood this was often due to staff being delayed supporting other people, we heard, "I understand because they [staff] get held up, sometimes it can be an hour late, I know if they are late, it's for a good reason."

Another person told us, "Staff are not always on time, they are late now and again but I’m still getting the same sort of care. I don't feel rushed. In the evening they seem to be in a hurry to get away." However, other people told us, they received their full care visits and did not feel rushed.

We received mixed feedback about communication and consistency of care staff. One relative told us, the person "[Relative] never knows which carer is coming or what time they will arrive" and some staff “Did not always communicate in a way which made the person feel valued.” This meant people did not always experience a consistent and predictable service.

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

People’s individual communication needs were assessed and recorded in their care plans as a guide for staff to refer to when needed.

People’s care plans detailed how they preferred to communicate and how they liked to receive and process information. This supported people to be involved in decisions, choices and conversations.

The provider made it easy for people to share feedback, raise concerns and be involved in decisions about their care.

Regular reviews were undertaken with people and, where appropriate, their relatives to ensure care continued to meet their needs. One person told us, "Yes they do [ask for feedback], and I also have spot checks with staff," another person said they had received a review "Within the first 6 months."

People knew how to raise concerns and who to raise them with and spoke positively about how concerns were responded to.

The provider analysed feedback received from people and relatives and shared the actions taken, demonstrating how feedback was used to drive improvements to the service.

The provider made sure people could access the care, support and treatment they needed when they needed it.

People received care and support, which was accessible and considered their individual needs. People were positive about the support they received. People’s accessibility needs were considered as part of the initial assessment and added into care plans to allow staff to understand access requirements.

Referrals to relevant agencies where people’s mobility needs had changed were made to ensure people accessed the care and treatment they needed.

Staff and leaders demonstrated an understanding of people's individual needs and tailored care and support to help them achieve positive outcomes.

People told us, the support they received enabled them to continue living independently and maintain the lifestyle of their choice in their own homes.

Care records contained clear guidance for staff, including when concerns should be escalated to the office or healthcare professionals, helping to ensure people received timely and appropriate support when their needs changed. Records demonstrated effective partnership working with healthcare professionals to promote people's wellbeing.

Staff received training in equality, diversity and inclusive practice, which was supported by policies, procedures and ongoing competency assessments to help ensure care was delivered in a fair, safe and person-centred way.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The provider had developed detailed and person-centred future care plans which reflected what was important to people at the end of their lives. For example, 1 person's care plan explored where they would prefer to be cared for, their wishes regarding pain management and treatments they may not want to receive.

The plan also recorded what would be important to them in their final days, who they would like to be present, any worries they had, what would bring them comfort, religious considerations and their funeral arrangements. This ensured staff had a clear understanding of the person's wishes and could support them in accordance with their preferences, values and beliefs.