Eleanor Nursing & Social Care Ltd - Brent Office

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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 service met people’s needs. At our last inspection we rated this key question requires improvement. At this inspection the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

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 provider made sure people were at the centre of their care and treatment choices. People received care and support from staff, and these were based on care plans that were produced following an assessment of their needs.

At our last inspection we recommended the provider considered best practice guidance on person-centred care and take action to update their practice. We found this action had been taken and people received care that personalised.

Care plans included information about people’s backgrounds, interests, social, sexuality and cultural or religious needs.People and relatives felt the service was personalised for them and they were involved in the care planning process. A person confirmed, “My care plan was discussed in the home initially and now, if necessary, by phone.Staff told us care plans helped them get to know people. They worked in partnership with people so they could respond to changes in their needs. Staff received training on the importance of person-centred care so that they ensured people remained at the centre of their care and treatment.

The provider was transferring to a digital system to store all care plans and records, which staff could update using their handheld devices. However, care plans were also available in paper formats in people’s homes.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible or supportive of choice and continuity. People and relatives said staff worked well with people they supported and consulted them. They told us they received care and support from staff they were familiar with, which helped with the consistency and continuity of their care. They felt they had access to care plans and would be involved if people’s needs changed. A relative said, “Initial care plan completed, not updated as no changes needed currently in [family member’s] care.”

Staff told us they understood people had a range of diverse health and care needs. A staff member said, “I get to know people by reading their care plans. It helps to understand their culture, background, preferences and care needs.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s communication needs were assessed and discussed during their initial assessment. This ensured staff knew how to communicate with people. Some people told us they did not have any communication issues and could freely engage in conversation with staff. The registered manager told us information was available in formats that were suitable for people to read, for example easy read or large print text. Staff were able to communicate with people appropriately and in accordance with their preferred method of communication should they have difficulties.

People and relatives were positive about the service and the level of communication. A relative said, “Communication with the carers is good. New staff shadow the regular carers so they get to know [family member].” However, some people and relatives felt communication from the office could be improved, for example when staff were running late or were going to come early. Comments from people and relatives were “They don’t usually let us know when the carer is running late.” Records showed staff followed procedures to notify the office team if they were late so that people could be informed formally.

The provider was also able to support people who spoke a certain language and match them with staff who also spoke the same language. Some people commented that there were occasional language barriers with staff, which we discussed with the registered manager. They assured us that they would address any issues and concerns around language or communication with people and relatives and resolve them.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result. A complaint procedure was available for people and relatives to use if they were not happy with the service or had concerns. Complaints were received and investigated in line with the provider’s procedures. People and relatives told us they could also speak with members of the management team if they had any complaints. They felt confident they would be listened to, and action would be taken to resolve any issues. A person told us they knew how to make a complaint and said, “Never needed to make a complaint but if needed we would go to the manager.” A relative said, “Communication is mainly by phone. I complained once about a new carer in the past but not needed to since. There was an appropriate response and it wasn’t a big deal.”

The provider made sure that people could access the care, support and treatment they needed when they needed it. Processes were in place to maintain fair and equitable access to services, including GP registration and referrals to occupational therapists, district nurses, and other professionals. Staff completed daily notes that summarised the care delivered and highlighted any changes in people’s needs, enabling timely responses to health concerns. Staff also received training in equality and diversity, ensuring they understood protected characteristics and the importance of providing fair and equal treatment to all.

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. The management team explained that individuals were assessed before starting the service to ensure their needs and preferences could be appropriately met.

These assessments explored each person’s diverse needs, and the registered manager demonstrated awareness of groups who may face barriers to equitable care, such as people with disabilities or mental health needs. Staff reported that they took account of people’s religious, cultural and personal backgrounds, showing respect for their social and cultural histories. They also recognised the importance of promoting equality, diversity, inclusion and human rights.

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. An end-of-life care policy was in place. People’s families were involved in any decisions about people’s future care and support.Records showed people’s end of life wishes were listened to and respected.