Great Care Health Services

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 is requires improvement.

This meant people’s needs were not always met.

This service scored 54 (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 care records provided person-centred information about people’s needs.

Care plans did not always provide person-centred guidance to staff on how to meet people’s needs. For example, where information was documented, it did not always contain sufficient guidance to ensure people’s individualised needs could be met. Care plans and risk assessments were not reviewed with people and relatives to ensure they remained current and reflected changing needs and preferences.

When we spoke with the provider, they demonstrated no awareness of the statutory guidance, ‘Right support, Right care, Right culture’, which supports the importance of autistic people and those with a learning disability receiving personalised care. This meant people were at risk of not receiving person centred care in line with the needs and preferences.

Staff demonstrated an awareness of the practical individualised support they provided people, which was supported by people and relative feedback.

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

Processes were not in place to ensure people’s care records contained relevant and detailed information about people’s needs. This meant staff did not always have guidance relating to people’s needs to ensure they achieved positive outcomes.

Safety event records which detailed incidents of risk and harm were not appropriately reported to CQC, doing so would have enabled greater joined-up working and greater understanding and learning. The provider’s failure to not adequately report notifiable safety events to CQC meant people were at risk of their risks and needs not being known and investigated.

People and relatives told us staff understood the health and care needs of the people they supported.

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

People did not have communication care plans and care plans and risk assessments made little reference to people’s communication needs and how these could be met by staff. This meant people were at risk of their communication needs not being adequately catered for by the provider.

Staff demonstrated an awareness of people’s communication needs, and the views of people and relatives supported this. One relative explained, “It takes a bit of time to get to know how [my relative] communicates; however, the staff take their time when speaking with them and don’t rush them when they are communicating.”

The provider did not always involve people in decisions about their care.

Once people’s care plans had been developed, people and relatives were not consistently involved in ensuring they were regularly reviewed to contain accurate, updated and person-centred information. When we spoke to 1 person about the contents of their care plan we reviewed, they told us they didn’t know they had a care plan, where it was located and what it contained.

A complaints procedure was in place, and staff, people and relatives told us they felt able to raise concerns and that they were confident these would be dealt with.

The provider sought the views of people and relatives through satisfaction surveys.
 

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

People’s care records did not always provide guidance about people’s needs, made limited reference to how people’s care had been informed by access to healthcare professionals, and they were not audited to support care remaining appropriate and responsive.

People and relatives told us staff worked flexibly around people’s routines and health needs to ensure access to support.

Staff listened were aware of the people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

An equality and diversity policy was in place, and staff had received equality and diversity training, which meant the service was aware of some of the challenges people faced in experiencing equitable outcomes.

Staff tailored support to people, so they had comparable experiences, regardless of disability, health condition, or background. For example, staff provided additional

mobility support so people could access activities within their wider community.

People achieved outcomes comparable to others, including maintained independence, improved comfort and consistent access to social opportunities. People and relatives told us

staff treated people fairly and responded consistently to individual needs, demonstrating equity in both experiences and 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.

While people were not in receipt of end-of-life care at the time of the assessment, people’s care plans mostly did not include information on the longer-term wishes and preferences which could be important to them.

The provider acknowledged this information had not been captured and stated their intention to address the situation by reviewing people’s care plans with them and / or their relatives.