Enigma Clinical Solutions Ltd

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. We previously identified a breach of the legal regulations in relation to person centred care. The provider was no longer in breach of this regulation, although some further improvements were made to records during the assessment. The rating for this key question 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.

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. However, care records were not always consistently completed.

Although improvements had been made, we identified some gaps in people’s care records, as previously described. This included inaccuracies in pre-service assessments, missing risk assessments and some inconsistencies in records. We found no evidence that people had been harmed, but we discussed this with the management team, who took action to improve care records immediately. Despite shortfalls identified, staff understood and respected people’s needs and preferences. People’s relatives confirmed this and told us they had been involved in an initial assessment of needs and ongoing reviews of support and care plans. One relative told us, “They know what he likes. The staff do what he likes them to do.”

People’s relatives told us they felt their family members were at the centre of their care. A staff member said, “We have time to get to know the person. It’s important that we don’t do things differently to what they want. Everything is person-centred.”

Staff told us people's care plans provided useful information about people's physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act. This helped them ensure people received appropriate support in the way they preferred.

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.

People’s relatives told us the service they received could be flexible, and staff liaised with health and social care professionals as necessary. Professionals gave mixed feedback, with some describing a lack of proactive communication.

Staff said they had a good understanding of people’s needs. They liked being able to support the same individuals regularly as this helped provide consistency to the person. Staff often lived in the area, so they knew the local communities well.

Staff received training which related to people’s needs, such as living with dementia and supporting people with diabetes. This enabled them to deliver appropriate care and support.

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

People and relatives told us they received information in a way they could understand. Individual systems were in place to ensure communication between people, families and staff was clear. This included white boards, notebooks and regular phone calls. Staff knew people’s individual communication needs and preferences, as well as any aids which were used. People’s individual communication needs were documented, although sometimes records needed to be clearer. Improvements were made to records following our inspection.

Information was recorded on electronic systems which were secure. Staff received training in data protection and security.

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 and their relatives had opportunities to give their views about the care they received. A satisfaction survey had been sent to people and relatives, but the response rate was low. Most of the relatives we spoke with did not recall receiving a survey. The registered manager sought regular feedback during phone calls, spot checks and reviews with people or their relatives. People and relatives told us they would speak with staff or managers if they had concerns or feedback. Most were confident they would be listened to and taken seriously, although we received mixed feedback about communication with the management team. One person told us they had taken issues to the registered manager and felt only some areas had been addressed. The registered manager was aware of these concerns and was reviewing their response.

A complaints policy was available and people were supported to raise concerns. We saw complaints were logged and investigated in accordance with the provider's policy, and action had been taken to make changes where possible.

The registered manager also shared examples of compliments from people and relatives who were happy with the support they had received from the service.

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

The management team and staff were aware that people could be disadvantaged when accessing treatment and care. They aimed to ensure people could access the services they needed without barriers or delay. This included when people’s needs changed or support was needed from other agencies. For example, with skin and pressure care, diabetes management or continence 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.

Managers and staff understood their responsibilities in ensuring people’s treatment and support promoted equality, removed barriers or delays and protected people’s rights. Policies and procedures provided guidance and consistency. Staff received training in equality and diversity, as well as specific subjects relevant to people’s specific needs. This helped improve staff awareness and understand how best to support people with different protected characteristics and reduce the risk of discrimination. People were treated with equity and the support they received met their assessed needs.

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.

During this inspection, we found some care records relating to end of life care had not always been completed or were not sufficiently detailed. For example, an initial assessment asked where people would like to receive care if their health deteriorated, and for some people the response was very brief and not specific. We raised this with the registered manager, who took action to improve the level of detail and personalisation in care records.

Despite this shortfall, the provider had received positive feedback from relatives when people had experienced important life changes, including end of life care.