Carters Green Healthcare Services 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.

This is the first assessment for this service. This key question has been rated 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 did not always make sure care records provided person-centred information about people’s needs.

Care plans, risk assessments and daily care records did not always provide person-centred information about people’s needs. While there were some examples of people’s care records containing some detailed and individualised information about people’s needs, we found this was not always the case. For example, where information was documented, it did not always contain sufficient guidance to ensure people’s individualised needs could be met. When this was discussed with leaders, there was a lack of an awareness of the statutory guidance, ‘Right support, right care, right culture’, which supports the importance of people’s care being personalised.

However, staff demonstrated an awareness of people’s individual needs, which was supported by relative feedback; and leaders sought the views of relatives regarding the care their relative’s received via satisfaction surveys, which were used to shape how people were supported.

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.

Although leaders advised there were systems and processes in place to ensure people’s care was regularly reviewed, as detailed in other sections of this report, these processes were not always effective in ensuring people’s care records were adequately detailed. This meant staff did not always have guidance relating to people’s needs to ensure they achieved positive outcomes.

Safety event records detailed incidents of risk and harm which were not always reported to stakeholders such as the local authority and CQC, where doing so would have enabled greater joined-up working and greater understanding and learning. The service’s failure to not always report notifiable safety events to others meant people were at risk of their risks and needs not being known and investigated.

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

The service user guide, which is a key source of information for people who use the service, provided up-to-date and detailed information.

Although some lacked aspects of relevant information, communication care plans were in place and provided information on how people communicated.

Staff demonstrated an awareness of people’s communication needs, and relatives told us how staff adapted their communication approach depending on the needs of people they supported.
 

The provider made it easy for people’s relatives to share feedback and ideas, or raise complaints about their care, treatment and support.

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

The service demonstrated they listened to and involved people’s relatives in shaping their care. The registered manager and senior colleagues sought the views of relatives on a regular basis via informal phone calls and spot-checks, care plan reviews and through satisfaction surveys.

Relatives told us staff and leaders listened to their views and, where applicable, changed their approach accordingly.
 

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

While people’s care records did not always provide adequately detailed and person-centred information, the continuity of care people received coupled with staff possessing a clear awareness of people’s needs meant people could access the care they required when they needed it.

Staff worked flexibly around people’s and relative’s routines and needs to ensure people received care at times that suited them.
 

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.

An equality and diversity policy was in place and staff 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, communication needs, or background. For example, staff used photographswith some people with communication needs to support them to be able to communicate and make choices.

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 did not include information on the longer-term wishes and preferences that were important to them.

The registered manager acknowledged this information needed to be captured and stated their intent to address the situation.