Continuity Health Care Services PVT 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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

This service scored 61 (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.

The provider did not always ensure care records contained sufficiently detailed, person-centred information to guide staff in meeting people's individual needs. Care plans and risk assessments were not always reviewed effectively to ensure they remained accurate, current and reflective of people's changing needs, risks and preferences.

As a result, people were not always supported in line with their assessed needs. For example, records instructed staff to complete skin checks and use pressure-relieving equipment, but there was no consistent evidence in daily records these actions had been carried out by care staff. In another example, a known trigger for a person's distress had been identified by management but had not been incorporated into their care plan to guide staff on how best to provide support.

There were some 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.

The provider generally understood people's health and care needs and worked with other professionals to support continuity of care. Staff were able to describe people's individual needs, and there was evidence of engagement with external healthcare professionals when required. A staff member told us, “If [person] gets an infection,theycansometimes develop short termconfusionwhich would be reported to theGP.”

However, systems were not always effective in ensuring risks were recognised and responded to promptly. Feedback from a visiting professional indicated the registered manager did not always demonstrate a sufficient understanding of risk and required repeated guidance to understand and act on concerns.

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

People's communication needs were generally met, and there was no evidence at the time of the assessment that people using the service required significant adaptations to support communication. The registered manager described how information and support could be adapted if required, including the use of large print and records translated to other languages.

Staff demonstrated an awareness of some approaches that could be used to support effective communication. One staff member told us, "I don't support people who can't communicate. Could use picture cards, speak slowly and clearly. Make sure hearing aids in where prescribed."

However, feedback indicated communication was not always effective. One person told us, "They are very caring, but they don't speak very good English."

People were given opportunities to express their views about the service. Feedback was sought through annual surveys and telephone calls with people using the service, which was analysed to identify themes and monitor people's experiences. One person told us, “Anything I need, any slight changes, I have a call from [registered manager]. It is really good communication.” Another said, “[Management] are approachable, that’s the point. If you go to them with a problem, they will listen to you and sort it.”

People and relatives were able to raise concerns, and records showed complaints were generally acknowledged and responded to. We saw examples where concerns had been investigated, outcomes communicated and learning identified. However, complaint management was not consistently robust. Although actions had been identified in response to concerns, records did not always clearly demonstrate how complaints had been investigated, resolved or used to drive improvement. In some cases, documentation lacked evidence of outcomes achieved, feedback provided to complainants, or learning identified. For example, where actions such as staff spot checks had been implemented, records did not consistently demonstrate how these had been completed, monitored or reviewed to provide assurance that concerns had been effectively addressed.

Oversight of complaints was further weakened by inconsistencies between complaint records and provider monitoring systems, with some complaints not recorded across all systems. In addition, complaints managed during the registered manager's absence by a manager from another service had not always been updated to reflect their conclusion, and some complaints had not been included within the provider's audit process. These gaps reduced management oversight and limited the provider's ability to demonstrate complaints were investigated, lessons learned were identified, and actions were monitored to ensure concerns were addressed and improvements sustained.

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

Care visits were planned around people's preferences and requirements, and people told us they were able to access support when they needed it. People generally experienced timely access to care and support. People and relatives told us care workers arrived on time and, where delays occurred, staff communicated with them appropriately. For example, people told us delays were usually due to traffic conditions or unforeseen events, such as care workers remaining with another person who required urgent medical assistance. One person said, "They had to send another care worker as there was a long wait for the ambulance one day." This demonstrated the provider took steps to ensure people continued to receive support when unexpected circumstances arose.

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.

People's experiences and outcomes were not always equitable, as the quality and consistency of care provided varied between individuals. While some people and relatives spoke positively about the support they received, weaknesses identified within care planning, risk management and governance processes meant people could not always be assured of receiving the same standard of safe, effective and person-centred care.

Records did not always contain sufficient information to support staff to meet people's individual needs consistently. In addition, the provider's oversight systems had not effectively identified or addressed concerns, resulting in ongoing shortfalls which increased the risk of inconsistent experiences and outcomes for people. As a result, the provider could not demonstrate that all people consistently received care and support that achieved positive outcomes.

People were generally supported to discuss and consider their future care needs. At the time of the assessment, no one using the service was receiving end-of-life care. Some care records included information about people's preferences and identified those important to them, demonstrating the provider had begun to consider future planning.

However, there were opportunities to further strengthen this area. Information about people's longer-term wishes, preferences and choices was not consistently recorded across all care records, meaning staff did not always have clear guidance should a person's needs change. Where future or end-of-life preferences had been documented, records were sometimes generic and lacked personalised detail about the person's individual wishes, beliefs, cultural preferences and choices for future care.