AA-I-Care - 35 Southwell

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 71 (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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People and their relatives were complimentary about the care and support provided by staff. Comments included, “I can’t speak highly enough of the care they provide. [My loved one] can be very difficult at times but staff are so good with [them]. I don’t know how I would have coped with the last few months without AA-I-Care.”

People received personalised care that was responsive to their needs, wishes and preferences. Care plans were on electronic format, staff had access to them on their smartphones. This meant any changes in people’s needs were shared immediately and staff were kept up to date with new information about people they cared for. Care plans contained person-centred details, including their goals, skills, abilities and how they preferred to manage their health. Staff had worked closely with people, their relatives and others important to them to ensure all their wishes and feelings were recorded. Staff had spent time with people and their relatives to gainreal insight, and demonstrated they knew people, their routines, wishes and preferences very well.

Care plans were reviewed every 12 months or more regularly if people’s needs had changed. This was done with the involvement of people who used the service and their representatives. Staff completed daily notes detailing the care they had provided which helped the management team to be aware of any changes in the person’s needs and ensure there was continuity of care.

Staff enabled people to participate in person-centred activities and encouraged them to maintain their hobbies and interests. Care plans outlined people’s enjoyment of activities and went into detail about how staff might get the best responses from individuals. People were encouraged to have goals and aspirations for the future, and staff worked hard to help people achieve these. One professional commented, “People that I have worked with who had / have AA-I-Care were living the best life that they possibly could, sometimes in difficult circumstances. I have observed first-hand some fantastic, person centred, caring care given from the carers.”

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.

People told us the service worked well with other professionals when needed. This included local GP surgeries, occupational therapists, social workers and pharmacies. Leaders were knowledgeable about people’s diverse health and social care needs. Staff made sure the multi-disciplinary team were involved when required. They gave examples of this and explained how other professionals were involved to ensure people’s wellbeing. We reviewed records of people who had regular input from other services; for example, there was input from the community mental health team, local GP surgery and frailty team. Staff worked hard to co-ordinate people’s appointments, making sure other professionals were aware of the person’s treatment and ongoing needs. Staff followed any guidance given, and provided information and feedback to professionals when needed, such as the effect of medication changes.

Comprehensive assessments were undertaken before care delivery commenced. People’s needs were fully reviewed to ensure their suitability for the service, and to facilitate a smooth transition from one service to another. Staff and leaders kept professionals up to date with any concerning information about people’s wellbeing. They were also invited to care reviews, which enabled coordinated and improved support for the person to be implemented. The local authority spoke positively regarding the care provision and shared examples of how AA-I-Care had made positive impacts on people’s wellbeing. One professional told us, “My client’s current live-in carer has developed a close and supportive relationship with the client, providing reassurance and consistent care. The provider communicates effectively with the client’s family, the carer, and myself to review and monitor the care arrangements. They have advocated for the client’s needs during reviews, ensuring appropriate support is in place.”

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

People were provided with ‘Service User Guide’ which outlined clear service agreements that detailed how they could raise concerns and what they could expect from staff.

The provider ensured people’s care plans and records captured how people were supported to engage in meaningful communication and decision-making. This enabled people to be active participants in their care if this was their wish. Peoples’ care plans clearly identified communication needs and what staff should do to support communication. This included ensuring people had access to any aids they required, such as prescription glasses and hearing aids.

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.

The provider had a policy and procedure in place that set out the steps someone would need to take to make a complaint, and information on how to complain was contained within the service user guide. This ensured all complaints would be investigated and a response provided to the person.

People and their relatives confirmed they felt confident in the service taking appropriate actions should they raise a concern or complaint, which included looking into the issue thoroughly, communicating what was happening, being open about what had been found out and what the outcome was. The provider worked with people to agree solutions to concerns raised, and to measure the impact of the changes made. People, their relatives and others important to them confirmed they had meaningful involvement in service development and improvement through regular and open communication. Feedback forms were distributed regularly, and annual care reviews were completed with people to give them an opportunity to discuss their support. One person told us, “I’ve no complaints, and I would just say if I did. It’s been really good.”

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

People's care records demonstrated that when they required the support and intervention of external health care professionals, this was provided. People were supported to attend health appointments and referrals to external health professionals were made in a timely manner for further assessment and / or guidance. This demonstrated people had access to the care they needed.

People were encouraged and supported to access regular health care reviews with a strong focus on prevention from further health deterioration. Comprehensive assessments covering the accessibility of people’s homes and whether any adaptations, equipment or referrals to occupational therapists were needed had been completed. External professionals confirmed this, “They are quick to make contact with professionals when there is a problem with the care package, or there is a moving and handling issue that requires occupational therapyintervention” and “They are quick to identify and report changes in skin breakdown, for example and take action to make contact with other appropriate services such as GP.”

When people changed from a different care service, we saw the provider actively working in partnership with other organisations. One relative told us: “[My loved one] had another [home care provider] and it wasn’t working. Then I found AA-I-Care, and they rescued us. If I hadn’t found them last year I would have had a complete breakdown, they have been wonderful.”

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.

The provider complied with legal equality and human rights requirements, including avoiding discrimination, having regard to the needs of people with different protected characteristics and making reasonable adjustments to support equity in experience and outcomes. For example, people with health-related mobility issues were provided with appropriate mobility aids to improve their experience and support independence.

All staff received training to help them understand equality and diversity and to identify and address discrimination.

People and relatives told us they had access to health care when needed and did not experience inequalities. They said their rights were promoted and they could share their views about their service through calling the office, regular care reviews and feedback forms.

People were fully involved in developing their support plan and risk assessments and could make changes at any time they wished. There were multi-disciplinary records in place and regular reviews of people’s care plans and risk assessments to ensure they were a true reflection of people’s current and changing needs.

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.

Staff were aware of people’s wishes for the future, for example whether they wanted to go to hospital for further treatment or whether they wished to remain at home. People’s care plans informed staff whether they had a DNACPR(Do not attempt cardiopulmonary resuscitation). DNACPR documents were stored in people’s homes. People’s lasting powers of attorney were documented in care plans, if people became unable to make decisions themselves. These decisions were recorded in respect documents, advanced care documents, and recorded in people’s care plans. However, the provider did not always recognise people’s individual religious, social and cultural diversity or values and beliefs, and how these may influence wishes and decisions about their end-of-life care. These were not recorded in people’s care plans. There was no evidence of recorded discussions with people or their relatives regarding end of life wishes and preferences.

Staff had not received training in palliative care to develop their understanding of caring for people at the end of their lives.

The provider worked with external health and social care teams including palliative care specialists and others, to provide dignified and pain-free deaths that were as comfortable as possible. People approaching the end of their life were identified, and this information was shared with relevant people, including other services, staff and people that mattered to the person. The manager told us they would contact person’s family if the end of life was approaching, advise them to visit and make arrangements for end-of-life care. They told us, “We work with the palliative team and district nurses’ team to ensure people receive the best end of life care possible. Staff know how to contact them out of hours. Managers or the palliative care team can go out at any time.” At the time of inspection, the provider was not supporting any persons receiving end of life care.