APT Care Central Bedfordshire & Bedford

On this page

• 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 Requires improvement. At this assessment the rating has changed to Good. This meant people’s needs were met through good organisation and delivery.
 

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Overall, 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.

People’s feedback about care and involvement was mixed but generally positive. Some people told us staff understood their preferences and responded to their requests. One person said, “Some carers are 80% and others are 120%. Communication between the carers is good and they are very caring and understanding when I still like to do some of the duties myself for my relative, the carers will stand back and let me do it.”

However, some people were less aware of their care plans or had not seen them. For example, one person said, “I don’t know if I have a care plan in place. The care I get is what I need, but I’ve never seen my care documented.”

Despite this, staff demonstrated a commitment to person centred care and responding to changes in people’s needs. They described observing changes and adapting care accordingly.

Records supported this, and care plans included personal information, life history and individual goals. Care plans were generally detailed and written in a personalised way, with evidence of people’s preferences, routines and aspirations. There were examples of staff supporting people to achieve outcomes important to them, including maintaining relationships, accessing the community and improving independence.

The provider did not always ensure care was joined up, flexible and supported choice and continuity in line with people’s assessed needs.

People’s feedback about continuity and consistency of care was mixed. While some people said they received support from regular carers and were happy with the service, others described frequent changes in staff and differences in care quality. One person said, “Communication between people could be improved. Once you get used to carers, they change them and it’s stressful for me because you have to start all over again explaining the duties.” Another said, “Sometimes you can’t talk to the carers, it’s not consistent nor is the quality of care from one to another.”

Review of call monitoring records identified concerns with how care was delivered in practice. Some calls were significantly shorter than the planned duration or took place outside agreed time windows. In some cases, visits were much shorter than expected. This meant care was not always delivered at the right time or for the full duration, creating a risk that people may not consistently receive the full care that had been agreed or commissioned. One person told us, “Overall, the service is okay, but the time is erratic. It’s not consistent at all, carers are not staying for the time we are charged for.”

There were also examples where care was flexible and responsive, including support provided to meet changing needs.

The provider had taken steps to improve this, including increasing management oversight through additional staffing and allocating field supervisors to defined areas to support continuity and staff development. They had also reviewed the rota and were implementing systems to prioritise consistent allocation of carers and strengthen monitoring of care delivery and risks. However, these improvements were not yet fully effective in ensuring consistent, reliable care for all people.

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

Information was shared in accessible ways to support people’s understanding and involvement. Records showed people had access to care plans, daily records and a service user guide with key information about the service, including contact details, complaints processes and people’s rights. Newsletters were also used to share updates.

There was an inclusive approach to communication. Information was available in a range of formats, including large print, audio and translated documents. Professionals confirmed this supported understanding. One professional said, “They provided a care plan translated into Polish and safeguarding information in Urdu and Bengali.”

Systems supported ongoing communication with people and their families, including telephone monitoring, home visits and digital access to care records. Staff understood how to handle information appropriately. One staff member said, “I keep all information confidential and only share it with authorised professionals.”

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People’s feedback was generally positive. Some people said they had not needed to complain, while others told us concerns raised had been resolved. One person said, “I have spoken to management once, but it was sorted out okay with the help of my relative.” This showed concerns were listened to and acted on.

Systems were in place to gather feedback, including surveys, telephone monitoring and home visits. Most people confirmed they were asked for feedback and knew how to make a complaint.

Complaints were monitored, analysed and used to improve the service, with actions shared with staff. There was evidence of learning from feedback, including changes to call times and staff practice. Provider analysis and survey results showed complaints had reduced over time and satisfaction levels had improved.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People’s experiences of accessing care were mixed. While some people said the service generally met their needs, others did not always feel able to rely on the service or access clear, timely information. One relative said, “They’re always chopping and changing carers. The carers are very inconsistent in every way from reliability to the unfamiliar faces and unexpected times like an hour late arrival. The office never tells us anything, you always have to push them for reasoning.”

Some people also experienced barriers to communication. One person said, “My relative doesn’t speak any English, and it causes issues when I’m not overseeing things.” This meant communication was not always accessible in a way that met the person's needs.

Another relative told us communication about delays or changes was not always consistent. This affected their ability to plan and feel in control. They said, “Sometimes the carers will come at unpredictable times. I need them to come on time for a reason, and this doesn’t always happen. They don’t always tell you when they been held up. You end up chasing the office because I’m kept in the dark. The quality of care is acceptable with caveats it could be better.”

The provider had already taken steps to improve this, including strengthening oversight and developing systems to improve consistency and monitoring. However, these improvements were not yet fully effective in ensuring people could reliably access care and receive clear information about their support.

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.

Staff demonstrated an inclusive approach to care and showed an understanding of people’s diverse needs. One staff member said, “Care is tailored to cultural, personal, and religious needs,” and another said, “We respect dietary preferences, language, and beliefs.” This showed staff considered individual differences in how care was delivered.

There was also evidence of wider awareness of equality and wellbeing. Records showed staff were supported with information about mental health and access to support resources, which helped promote awareness of emotional and mental well-being for both staff and people using the service.

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.

Staff demonstrated a clear understanding of good end of life care and the importance of planning ahead. One staff member said, “Good end-of-life care is calm, compassionate, and focused on comfort, dignity, and the person’s wishes.” Another said, “Good end of life care means comfort, dignity, pain relief and family support. I work with GPs, district nurses and palliative teams.”

Records showed care was adapted in line with people’s changing needs and preferences, including where care was declined or adjusted. End of life plans were documented where appropriate, including people’s preferences and clear guidance for staff on pain management, dignity and consent. Records also showed family members, including those with lasting power of attorney, were involved in planning and review discussions.

Staff monitored deterioration, escalated concerns and worked with external professionals to provide coordinated care.