B24 Healthcare Solution 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.

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 64 (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 records were person-centred and included information on how the person wanted to be supported. Some protected characteristics were recorded in care plans and this included information about people’s religious beliefs and disability.

There was mixed feedback about whether people could access their care plan. The provider told us paper-based care plans could be made available to people if they wished this.

Most people and their relatives were happy with their care and support.

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 provider had ‘teams of staff’ who covered care calls within specified geographic areas. Rotas were arranged by the care co-ordinator who completed the allocations in line with people’s preferences related to the gender of care staff.

Most people told us they had a consistent team of staff undertaking their care calls.

The provider did not always supply appropriate, accurate and up to date information in formats tailored to individual needs.

People’s communication needs were recorded in their care plans giving staff information they needed. We received mixed feedback from people and their relatives about staff’s verbal communication with them. Some people and relatives told us staff chatted to their loved ones and positive communication took place. One relative told us they were pleased staff undertaking care calls to their loved one were able to speak their (non-English) language with them. However, other feedback about communication was negative. For example, 1 relative told us, “My relation is a bit deaf, some staff have such strong accents, they have no chance in understanding and communication is a massive problem.” Another relative told us, “Not all staff speak clear English.” Another relative told us, “Some staff don’t speak a lot of English.”

There was no record in staff files of the provider having assessed staff’s spoken English communication skills to ensure this met people’s communication needs and would be effective in an emergency such as contacting the emergency services.

The provider met the requirements of the Accessible Information Standard. We reviewed 1 care plan available in an accessible pictorial format and the provider told us if other people required accessible formats these would be made available.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

The provider did not always give opportunities to people and their relatives to share feedback with them through a survey or their complaints policy. Some people or relatives could not recall having received a survey and we found the last feedback survey was only sent to 26 people with no rationale for the low number of participants.

Of those who participated in the survey, people were happy with their care, but some concern was shared about communication related to late care calls. An action point to make improvements was to ensure people were promptly informed if their care call was running late. However, feedback to us showed this action point had not been fully implemented. This meant whilst people and their relatives were involved, actions were not always sustained or embedded into practice to make improvements where needed.

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

People’s communication needs were recorded in their care plans including if the person used hearing aids or wore glasses to read.

Staff gave us examples of supporting people to access services. For example, 1 staff member told us, “If a person is running low with their medication, I make sure their relative is aware so they can request new stock.” Another staff member said, “I will contact the district nurse team if I am concerned about a person’s skin.”

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 had received training in equality and diversity and demonstrated a commitment to promoting people’s rights and choices when supporting them. Care records directed staff to promote people’s rights by gaining people’s consent prior to supporting them.

The provider and management team assured us people were offered a choice of the gender of their care staff as we found care plans did not always record this. The deputy manager was able to give us an example of a person who had gender-specific wishes related to their care staff and rota planning took account of this person’s wishes. Care plans did not always reflect people’s protected characteristics. However, no one spoken with raised this as a concern and the provider assured us this information would be recorded in future.

People were not always 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 had completed training on dying, death and bereavement and felt they could support people with this if needed.

However, only 2 of the 11 care plans reviewed included any information on planning for the future or a record of any discussions held with people regarding their end of life wishes. This meant staff did not always have important information to refer to if needed when a person’s health deteriorated.

One person’s care plan stated they had a DNACPR (Do Not Attempt Cardiopulmonary Resuscitation) in place and where this was located. However, there was very limited information about what their advanced wishes were.