Cheshire Support 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 the provider met people’s needs.

This is the first comprehensive assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. This meant people’s needs were not always met.

The provider was in breach of the legal regulations in relation to good governance.

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 ensure a person-centred approach to planning people's care. Care plans did not always reflect people's choices, likes and dislikes, they were task focused and did not consider people's whole life needs. When people had specific health conditions, standardised information was included in care plans. This was not supported by individualised and person-centred care plans detailing how these conditions affect the person. However, staff knew the people they supported and could describe how they provided care in line with their preferences.

The provider understood the importance of people being familiar with their staff and having continuity in their care. People who had regular staff supporting them were happy with the care they received. Most people told us the same staff supported them most of the time and our review of people’s calls confirmed this. This helped ensure good continuity of care and helped staff build positive relationships with the people they supported. Comments included, “We have the same team, [Person] recognises their faces” and “We have the same team of 5 carers."

The provider had not consistently considered how information could be made accessible to people. Whilst care plans contained some basic information about people’s sensory needs, there was limited evidence assessments had been completed to determine whether information should be provided in alternative formats to support understanding. Most people and relatives told us they did not have a copy of their care plan. This did not support their understanding of the support to be provided in relation to their care needs.

However, prior to people moving to alternative care providers, we were assured staff provided information about what to expect from the process, so they felt informed about the transition.

The provider did not always operate effective systems to involve people in decisions about their care. Records did not assure us regular care reviews had taken place with people. This limited opportunities to ensure care continued to meet people’s needs and preferences.

The provider had sought feedback from people through surveys, and we saw most responses were positive. However, where people identified potential areas for improvement, records did not assure us this had been analysed and acted upon.

The provider did not always operate effective systems to identify and address potential barriers to equitable access. Once a referral was received, the provider did not always ensure people received assessment in a timely manner and information shared by external professionals was not always used to develop detailed care plans. Whilst we did not identify impact on people, these practices increased the risk some people may experience barriers in accessing care and support at the times they need and in a way they required.

Staff and leaders did not always ensure an effective approach to care planning for people who were most likely to experience inequality in experience or outcomes. People's care plans and risk assessments were not always completed, up to date and reflective of their current needs and they were not always effectively reviewed to ensure they remained relevant. For example, a person's care plan had not been reviewed since July 2023 and contained very minimal information about their care and support needs and how they were to be met. The provider was unable to demonstrate effective systems were in place to monitor and promote equitable experiences and outcomes for people.

However, the registered manager responded positively to our findings and committed to a series of actions to improve assessment processes and improve the quality of people’s care records.

People were not always supported to plan for the future. Care plans relating to people’s end of life wishes were incomplete, including for some people who were currently receiving end of life care. This meant important information about people’s preferences and choices may not have been available to staff when needed. However, staff had received end of life care training.