Winners Trophy

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 registered service. This key question has been rated requires improvement. This meant people’s needs were not always met. The service was in breach of legal regulation in relation to person-centred care.

This service scored 46 (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.

There was a lack of information in some people’s care plans to reflect their personal preferences. Some care plan information was noted to have been copied and pasted from the local authority assessment support plan. Three documents for one person which had a different person’s name in the narrative. Care plans did not consider nationally recognised evidence-based guidance and did not always include all details of people’s health, emotional, social and cultural needs. People provided mixed feedback about person- centred care. For example, one relative told us their family member would prefer and would work better with a female care worker, but they were told there wasn’t one available, so they had to adapt their preferences to fit in with the service’s needs. The registered manager told us they always ask people for their preference of either a male or female support worker but as they only have a small number of staff, preferences cannot always be met. They told us they would explain to the person they can only offer a male or female staff member and people can either accept or decline and go with another company.

However, staff were able to tell us how they provided person-centred care for people they supported.

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.

For example, it was noted during the inspection, one service user, where professionals or family members with the appropriate legal authority, had not been involved in making decision about restrictions being placed on a person. Documentation reviewed showed there was minimal contact with professionals on behalf of people to be assured the restrictions were appropriate and in line with guidance. The registered manger told us, “We will contact social services or put in referrals for occupational therapists, but we haven’t had to do this very much.” We received mixed feedback from relatives of people using the service. For example, one relative told us, “Professionals are involved with [Person], but it does not really have anything to do with Winners Trophy staff, this is separate.” Another person told us, “[Manager] rings me up and asks me different things and talks to social workers and such for me. I think I’m very lucky to have them on board.” Partners did not raise any concerns about the way the service ensured continuity of care for people.

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

Some people told us they had not received an up-to-date care plan and found the electronic application to read their daily notes difficult to access. We asked the registered manager to describe the Accessible Information Standards (AIS), and they told us, “I understand this is a new thing which is coming up. I think we’re all adapting into it and there is so much input to be put into it.” They were able to describe how to support and communicate with people with hearing impairments. The provider had an AIS policy in place and staff were able to demonstrate how they adapted their communication needs for different people. One staff member told us, “I had one person who couldn’t hear so I wrote things down for them.”

The provider did not 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.

People told us the provider did not ask for any formal feedback about their care. There was no process in place for the provider to regularly seek feedback from people and the registered manager could not confirm how often they sought people’s feedback. The registered manager told us people could feedback via the homecare.co.uk website and they had received some responses from people. People told us they could speak with the registered manager as and when needed but some people did not know how to raise a formal complaint about the service. One person told us they had raised a complaint but felt, “There wasn’t a transparent approach to the complaints process. Rather than the manager being open and responsive and trying to learn from the concerns and why it happened they were on the defensive. It did not make me feel like I could complain properly.” The registered manager told us they had not received any complaints about the service and a copy of the complaints policy was left at people’s property during the initial assessment. The provider had a complaints policy in place which stated, “Complaints should be made in writing on the form, this is available from our office directly or can be downloaded from our website.” However, during the inspection we were not able to locate the complaints form on the website.

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

Most people told us the provider did not contact professionals on their behalf, and this was mainly completed by family members. There were limited examples to demonstrate where the provider had taken steps to ensure people had access to services needed. However, staff told us people had access to the support they needed, and they would contact the office if a referral needed to be placed.

A relative also told us emergency services had been called when a person was ill. One partner told us the service had regularly kept in contact with them about a person they were supporting.

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’s own equal opportunity and discrimination policy did not highlight all the protected characteristics outlined in the Equality Act 2010 and some of the terminology within in it could be deemed discriminatory against staff.

Care plans did not always contain current legislation and nationally recognised evidence-based guidance about people’s diagnosis for staff to understand how to manage people’s needs. One person told us, “[Person] has dementia and does tend to decline things, and I’ve noticed some things are missing in the notes. For example, [Person] will tell staff they had a shower, but [Person] hasn’t had a shower, they will just document it to say [Person] told them they had a shower. I see [Person] every day, it’s clear when they haven’t had a shower, staff don’t pick up on the fact that they have dementia and will say things have been done but it hasn’t.” The person’s care plan showed they had a diagnosis of dementia and needed promoting and encouragement with personal care, but there was no information available for staff to follow to be assured that personal care had been undertaken prior to their arrival. The service’s staff training matrix showed some staff had completed equality, diversity and human rights training; however not all staff names were available, and evidence submitted by the provider did not show all staff had completed thetraining.

However, staff were aware of the need to ensure fair and equal treatment to everyone and one staff gave an example of where they had requested additional time for a person with a specific diagnosis so they had time to complete the care and support, to fit in with the person’s needs.

People were 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.

At the time of the inspection no service users were being supported on end-of-life care, but care plans reviewed did identify people’s wishes about their future. For example, one care plan noted, “The DNACPR is in place and reviewed every 6 months and the GP and family are involved.” One person told us, “Yes, they asked this and there is a copy in the drawer and staff know about this.”