Timeswitch Care

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.

This is the first assessment for this service. This key question has been ratedrequires improvement.

This meant services were notalwaysplanned or delivered in ways that met people’s needs.

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.
Care documentation provided a wide range of information as to people’s needs, however, these did not always provide a full holistic overview to support people to receive person centred care. There was also vital information missing in people’s care plans. For example, we were advised verbally people had a do not resuscitate (DNAR) document in place, however, this was not documented in people’s care plans. There was a lack of documented evidence people had been involved in discussions about their care, however people were given opportunity to feedback via a survey. However, we did not find any impact to people using the service. The provider has assured us how they will make improvements to person centred care including staff attending care planning training. People we spoke with told us they had been involved in care plan reviews. One relative told us, “I am involved in the care plan, it is reviewed if there is any change.”
 

There were 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.
Although care plans did detail some relevant information regarding people's needs, care documentation lacked important information, and at times contradicted leaders and staffs understanding of people’s needs. Information which had been shared from the local authority assessment regarding people’s needs, for example, health needs, were not always incorporated into people’s care plans. For example, people living with a stroke. The service was provided the relevant health information from the local authority as to how a previous stroke may affect mobility, however, this information was not always evidenced in care documents. Therefore, the provider was unable to always work closely with relevant services to support choice and continuity, as there was a lack of a full awareness of people’s needs. The provider told us how they will make improvements in this area, including a full care plan review for all those using the service and appropriate training will be put in place for staff.
 

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

There was a complaints, suggestions and compliments policy in place which advised how people or relatives could make a complaint and how the service will promote accessible information standards. However, we were provided no examples from the provider as to what information is shared with people or relatives when they start being supported by the service. For example, complaints or safeguarding information shared with people. We reviewed care documentation, and where people required accessible information, this was not always well detailed as to how accessible information was provided to people in an alternative format. For example, in another language.
 

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.

Care reviews had been completed by leaders in the service, however, there was no documented evidence people had been involved in discussions about their care. People were provided the opportunity to give feedback on care in the form of a survey. The provider’s complaints, suggestions and compliments policy states staff will undertake relevant complaints training, however, there was no evidence this had been completed. However, we did not find any impact to people using the service. The provider assured us systems will be put in place to ensure people and relatives feedback through care plan reviews is thoroughly documented. People we spoke with told us they were able to provide feedback on their care.
 

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

Although some health information was included in care documentation, these did not always detail important information, for example information which may put people at increased risk of inequality under the Equality Act 2010 (EA, 2010). For example, where people had historical poor mental health. There was no information or risk mitigation provided as to who staff should contact should people’s presentations deteriorate, such as, a mental health crisis team. We were not always assured staff had received robust, sufficient training as to how to recognise people may be unwell, and when to refer people to health professionals. For example, where staff were responsible for medications, appropriate medication competencies had not been completed. We found no impact to people during our assessment, however, there was a risk staff would not always recognise signs of deterioration and when to refer to other health professionals. The provider has advised us how they will make improvements regarding their systems and processes which impact equality of access. People we spoke with advised of no concerns regarding equal access to services.
 

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.
The provider had an equality, diversity and inclusion policy in place. Staff had received training regarding equality and diversity. Care documentation detailed information regarding people’s needs which may put people at increased risk of inequality under the EA, 2010. However, the information provided needed to improve. For example, where people did not have English as a first language, there was some evidence provided as to how people would be supported to understand their care interventions, however, the information did not incorporate what efforts the provider had made to maximise people’s communication, for example, use of interpreters or alternative written formats. People we spoke with did not express any concerns regarding equality of outcomes and experiences.
 

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.
Care planning documentation lacked any information regarding people making important decisions about their life, including end of life care. For example, where people had a DNAR in place, there was a lack of specific information as to people’s wishes. At the time of the assessment, there was no evidence staff had completed end of life training, however, the provider has now provided evidence some staff have completed the training but this was not consistent across the service. People told us there were no end-of-life plans in place for them at the time of the assessment. However, we did not find any impact to people using the service. The provider assured us all staff would complete relevant training in this area.