Almag Healthcare Limited

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 newly registered service. This key question has been rated Requires Improvement. This meant people’s needs were not always met.

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 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.

The provider’s assessment and review processes, along with the guidance available to staff, were not sufficiently robust to ensure people consistently received person‑centred care. The shortfalls identified in the Key Questions of Safe and Effective demonstrated a lack of partnership working with people to understand, plan and review their unique and current care needs. In discussion with the registered manager, they acknowledged that improvements were required and took some immediate actions. This included meeting with people to discuss their care needs and updating care plans accordingly.

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.

A person who used the service and their relatives repeatedly told us there had been a lack of consistency from regular care staff when they first began using the service. This had a negative impact on their initial experience, as they often had to repeat information about their needs and preferences to different staff. However, they acknowledged that improvements were now being made.

The staff training matrix showed gaps in training relating to some people’s known health and care needs. We discussed this with the registered manager, who told us they were in the process of exploring additional training to ensure staff had the skills and knowledge required to support people safely and effectively.

The provider’s care package review procedure had not been formalised. The registered manager shared their plans to develop and implement a structured review process. This needed to be implemented, fully embedded and sustained to enable greater oversight of people’s changing needs, ensure care plans remained current, and support more consistent, person‑centred care delivery.

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

A reoccurring concern raised by a person who used the service and relatives was a lack of information provided by Almag Healthcare Limited. People told us they had not been given a copy of the provider’s Service User Guide or similar document that informed them about the service, what to expect including contact details.

A person said, “I've seen no documentation. I've got no details about how to contact the service it was a care staff member who gave me the manager's number last week.” A relative said, “I've not signed any documentation and [name] is not able to, I've got no copies of care plans in the house anything that I've seen. I've got the manager's contact number, but I don't have a contract, service user guide or anything about the service.”

We discussed the feedback we received with the registered manager, who took immediate actions to address these shortfalls.

The Accessible Information Standard (a legal requirement for social care providers to ensure information and communication are provided in ways that meet people’s needs and can be understood) was not being met. Guidance for staff about people’s individual communication needs was limited in detail. For example, where people’s communication or comprehension was affected by their health condition, and this impacted their ability to express pain or their emotional wellbeing, the guidance available to staff was either limited or missing.

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.

The provider’s systems and processes used to monitor complaints, concerns and feedback had not been formally implemented. Whilst the registered manager told us they had received no complaints, we were aware from feedback from a person who used the service and relatives they had experienced late calls, and this was a concern to them.

The registered manager told us their quality assurance and care package review process that sought feedback from people who used the service and relatives was in the process of being implemented. Where the registered manager had spoken with people and or their relative about the experience of the service, this had been done informally and had not been recorded. This meant there was no clear audit trail of concerns raised, actions taken or learning identified, limiting the provider’s ability to monitor trends, respond proactively, and drive continuous improvement.

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

The provider had not made it easy for people or their relatives to access the service when needed, as they had not been given the contact details for the service. This had led to delays and missed opportunities for people. One person told us they had missed a hospital outpatient appointment due to the timing of their care call. They explained they had a second appointment scheduled, and on this occasion a staff member had changed the time of the care call to accommodate the appointment, which they appreciated.

Staff were aware of their roles and responsibilities in escalating concerns to the registered manager to prevent people experiencing barriers to their care and support. A staff member told us they had reported that a person’s care call duration was not long enough. This was escalated to the registered manager, who contacted the local authority to request a reassessment.

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.

No concerns were raised during this assessment in relation to discrimination. The provider had an equality and diversity policy in place, offering guidance on the importance of treating people equally. This was supported by staff training.

Relatives told us the service supported them to care for their family member at home in the way they wished. This demonstrated the provider’s commitment to promoting inclusion and supporting people to live in a way that reflected their identity, values and personal choices.

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.

People’s end of life care wishes had not been discussed and planned with them. This meant there was no specific care plan that provided staff with guidance that reflected the person’s choices, preferences or priorities at the end of their life.

Important information relating to legal decisions, such as Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) forms and other advance care planning documents, were not consistently recorded. It was difficult to determine whether people had documents in place outlining their future end‑of‑life decisions. This meant the provider’s systems and processes were not sufficiently robust to ensure people’s wishes were known and understood, which could impact staff’s ability to provide responsive and safe care aligned with people’s preferences.

Care plans were not consistently outcome focused. This showed a lack of clear planning around what people wanted to achieve, maintain or improve in relation to their health, wellbeing and independence. For example, some care plans did not identify personal goals such as maintaining mobility, managing anxiety, or supporting meaningful daily routines. Without this information, staff did not have the guidance needed to support people in a proactive and person‑centred way.