Mobile Care Services Limited

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 good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 50 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Gaps identified in important information and omissions in some records and guidance, such as for transdermal patch medicines, meant the provider placed people at risk of potential harm. These omissions demonstrated a lack of robust systems to ensure care remained responsive to people’s individual needs and in ensuring staff always had the information they needed to provide care and support safely.

At team level, care staff understood the importance of taking a person-centred approach when caring for people. The provider had teams of staff who covered specific geographicalareas, and these were co-ordinated by a team leader who knew people, the locations and the staff team well.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

During our inspection we found information made accessible by the provider, to team leaders and the manager, lacked detail. This made it difficult for Mobile Care Services Limited’s office staff to check on whether people were receiving the correct number of minutes / hours in allocated care calls. For example, team leaders could not consistently find information on how many hours care had been delivered, against commissioned hours. The manager told us this was sent to them weekly from the provider’s head office. However, the information shared had only a total figure for Mobile Care Services Limited as a whole and not by person, area, or local authority. When we reviewed the care hours delivered to 1 person, we found they had only received 59% of their allocated time over a 2-week period, with no rationale for this.

Staff training updates were behind and not all staff had received checks on their skills before they began delivering care.

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

There were some alternative format documents available to people who may struggle to understand written formats. For example, a ‘Customer Guide’ was available in an easy read format. However, not all other information was. For people, for example with a learning disability, there was no evidence that consideration had been given in creating an easy-read or pictorial assessment or plan of care for people. Whilst most people could communicate their needs verbally, the manager acknowledged there was further work to be done in meeting the Accessible Information Standard.

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.

Some people and relatives told us they had raised issues and these had been resolved. However, others told us their issues had not been resolved. Some people and relatives told us they felt office staff’s communication skills needed to improve as they felt they were not listened to.

The manager and office staff had given some people and relatives opportunities to share feedback, for example some people had been phoned for feedback immediately before our inspection. However, some people and relatives did not always feel their feedback was used to make improvements where needed.

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

Some people and relatives told us they had felt involved in making decisions about using the service, in their initial assessment and ongoing care and support, while others did not agree with this. Some people and relatives told us they had not been involved in making a choice about their care and support, nor could they recall being involved in planning their care.

The manager told us they encouraged care staff to contact office staff if they had concerns about a person’s needs. For example, if they felt a GP or district nurse intervention was needed and they would make a referral on behalf of the person if needed.

Staff and leaders did not always evidence that they actively listened to information about people who are most likely to experience inequality in experience or outcomes.

Whilst the manager and staff team were aware of inequalities and the prejudices people receiving support may face, care plans did not always reflect how staff could enable people to achieve outcomes.

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.

The manager told us people were supported with end-of-life care. This was done alongside other healthcare professionals in people’s own homes, where people wished to remain at home. One person’s RESPECT (DNACPR directive form) had been completed by healthcare professionals and detailed the person’s wishes and staff were able to refer to this if needed. However, the provider’s care plan documents needed improvement to include end of life care planning and to offer people the opportunity to share their wishes for the future.