Candlelight Homecare Service Limited (East Sussex)

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 remained 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 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.

People received care and support that was personalised to their needs and choices because staff knew them well. Care plans had been developed with people and where appropriate their relatives. Care plans included details that enabled staff to provide the care and support people required and chose. For example, they included details of people’s routine, how they liked care provided and where items needed to support the care, such as where clothes were kept. This helped ensure staff knew about the person before they provided care.

However, we identified that improvements were needed to some aspects of care plans. Some people had companionship calls. These were to allow people time to engage in certain activities or others to give their loved ones a period of respite from their caring role. Some companionship care plans included details of what the person liked and the support they required. Others stated only to sit with person to ensure their safety. We discussed this with the registered manager and nominated individual. They told us that improvements would be made to ensure all aspects of people’s care is person centred.

Daily notes did not fully reflect what people had done each day. They did not detail what actions had been taken, for example, if people had declined care. One relative told us they had access to their loved one’s online care records. They told us,” To put ‘have completed this’ doesn’t say much about what they actually did or how anything about how [name] was, e.g. tired or bright? sleepy or alert? Happy or concerned about something? Which would be much more informative both to the office and the family.”

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 service focused on supporting people to receive the support they wanted. They recognised the value of continuity of care staff and developing trusting relationships to enable people’s sense of wellbeing and independence. There were systems in place to support people to receive care which was joined up with relevant services. Specific training was provided to staff to support people using the service. For example, staff who supported autistic people and people with a learning disability had completed further training to ensure people’s needs were met appropriately.

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

Some people had health conditions that could impact on the way in which they communicated. Information about people’s communication needs was not available in all care plans where people may need support. However, this was somewhat mitigated because staff knew people well.

People and their relatives told us they were able to contact the registered manager or staff at any time for information. However, they were not always updated about changes to the rota.

A relative said, “Time changes after the rota is sent out aren’t passed on to the relatives and one time, they came so late family had helped [name] and we had to send carers away.” The registered manager told us this had been a further impact of the merger and issues were starting to resolve. The registered manager identified this was an area for further improvement.

When people started using the service there was information about how they would like to communicate with the service. This included face to face, emails, or phone calls. Where information about communication was in place this described how people liked or were able to communicate, for example breaking information into small sentences. Staff told us about a person who was hearing impaired, staff were able to use a British Sign Language app on their phone to communicate with them. When the person attended appointments, staff ensured the person was supported by an interpreter.

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.

One relative told us, ‘I am able to complain if I need, I would speak to [name] or [name]. [Name] does the reviews which we have every 3 to 6 months.” A further relative told us about reviews that had happened in the past but did not think there had been one recently.

People and relatives told us they knew how to make complaints or raise any concerns. One relative told us about a complaint they had made and how this had been addressed to their satisfaction. Another person said, ‘I haven’t had much to do with the office, but I am able to contact them, and if I had a problem would be happy to raise it with them.’

Annual feedback surveys were sent to people, relatives, and staff. These had been sent out prior to our inspection, and the provider was awaiting the responses to analyse and identify areas of good practice and areas for development.

Staff completed reviews with people, this gave people and their relatives to feedback any areas of concern or changes they would like to their support. There was a complaints policy and complaints received were responded to appropriately and used to develop the service.

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

People were involved in planning their own care and support. They were able to choose the times of the visits, although there had been some recent impact due the issues at the service. There were on-call arrangements so people and staff could contact the service for advice and support out of hours. Staff received equality and diversity training and had a good understanding of how to ensure people were treated fairly.

The registered manager and staff worked with people, relatives, and other healthcare professionals when appropriate. This supported people to have access to advice or care they needed.

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 worked to ensure people were not subject to inequality or discrimination due to their age or disability. They supported them to receive the appropriate care and support by building relationships with people, their families and those who could support them. Staff understood how to speak with people to support their specific needs and knew the best way to enable people to participate in decisions about their experience of care. Staff told us they supported a person with a learning disability to a medical appointment. The medical professional addressed all their questions to the staff member and not the person. The staff member did not answer on the person’s behalf but supported the person to respond directly to the professional themselves.

People were 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.

Do not attempt resuscitation (DNACPR) and Recommended Summary Plans for Emergency Care and Treatment (ReSPECT) forms were in place detailing people’s wishes and choices. However, individual end of life wishes had not been explored with people by staff. We were told this was something that would be considered for the future.