Caremark (Wokingham and Bracknell)

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 changed to requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulations in relation to person-centred care and safe care and treatment.

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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

The service had not ensured people’s care was person-centred. People’s care records were not written in a person-centred way and therefore people did not receive responsive, personalised care and support that met their needs and reflected their preferences.

A person told us their care plan was not read by staff, the staff had not understood their individual health needs and when the person requested support from the service in being supported when staff were changed on the rota, the person was not supported. We were told this caused the person distress.

People were continuously referred to as ‘client’ within their care records. For one person with complex needs, the care records did not include a specific risk assessment for this need.

Care records did not include information on how to support people to minimise the risk of falls. Care records had not been updated to include recent information, current care times were not recorded to support a person who required time specific medicines and notes were unclear on what the specific risks were to people if medicines were not taken.

Care records had a section that specifically required completion for “Diagnosed medical conditions and how they affect me.” Some of these diagnoses included benign intracranial hypertension, hearing impairment and hypothyroidism. These sections were not completed fully to record how people were affected. Therefore, we were not assured that staff could provide person centred care, as information about people and their needs was not available to them.

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.

People and relatives told us they did not always have regular staff. We were told, “but I panic if it [staff] is a different one.” We were also told “It would be better if we had the same people coming in, [person] has dementia.”

Care records did not guide staff in supporting people diagnosed with autism and learning disability. Therefore, staff were not able to deliver care and treatment that met people’s needs.

The provider had not always ensured information was available in formats tailored to people’s individual needs.

People’s individual needs to have information in an accessible way were not identified, recorded, highlighted and shared. These needs were not met or reviewed to support their care and treatment in line with the Accessible Information Standard.

Reasonable adjustments were not made for people who required information in another language.

People told us they did not have a rota as they “don’t understand computers” and they do not have the online application as they “can’t cope with it” but the staff will inform them of any changes.

Some people told us the information from the service is shared with their family members and, “I get an email with the rota and if there are any changes to times etc they notify me.” However, one person told us they receive the rota by email, they have difficulty reading a screen, need pictures and, “I don’t do names well.”

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

People and relatives gave us mixed feedback. People told us they could contact the service if they needed to and had been contacted for verbal feedback. However, not all people thought they had received a feedback form. One person told us, “I have had a feedback form, they just need to understand my needs.”

Relatives told us they contacted the service if they needed to. We were also told, “The best improvement would be to have the same carers” and “really the consistency of care is a problem.”

Surveys for staff and people were sent out, the responses were looked at by the provider. However, feedback from staff and people was not analysed for themes and trends, therefore the service could not continuously improve the service. There were no actions following this feedback. Therefore, the service was unable to identify where improvements needed to be made. There were no metrics for monitoring the outcome of any changes informed by the information gathered. As surveys were also anonymous, limited action could be taken to follow up on specific people’s concerns, and there were no actions following any feedback recorded.

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

Professionals told us when extra support was required, the service provided this and the service reported missed calls and reasons for the missed calls. However, people and relatives gave us mixed feedback. Whilst they told us they could contact the office, we were also told the time schedules and certain times requested could not be accommodated. We heard, “I am not supposed to ring the office until it is half an hour past the call time.”

We were not always assured people could access the care, support and treatment they needed when they needed it.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes.

The provider had not always fully considered the needs of people who were more likely to encounter inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People’s mental health needs had not always been fully considered and there was a lack of detailed guidance about how to support people’s mental health and ensure any concerns were managed appropriately. Care records were not consistent in recording mental health needs including depression nor was there guidance for staff on how to support people.

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.

The registered manager told us they were not currently supporting any person on palliative care. Care records included a section to complete for ‘Planning for the Future.’ However, it was unclear from the care records how 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.

Care records did not show how people were supported to make informed choices about their care and plan their future care while they had the capacity to do so. We were not always assured people were supported to plan for important life changes and to make informed choices about their care.