Collaborative Care Solutions

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 remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 had made improvements in this area since our last inspection. They made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. Whilst people felt the support they received was person-centred, care records lacked detail on occasions. The management team acknowledged this and assured us they would continue to develop the level of detail within people’s records. People told us they reviewed their care plans with staff on a regular basis. They told us how they had recently been supported to develop a plan to visit a friend who used to live with them. They had wanted to visit independently, and staff had helped them plan this, so it was safe for them to do so. One relative confirmed their family members care plan was reviewed with them and took into account their goals. They told us, “As a family we visit regularly and are able to be involved in reviews. We all work together to find ways around any difficulties.”

Staff confirmed any updates to people’s support plans were flagged to them on the electronic recording system and also discussed within daily handover meetings.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. People were supported to access different resources within their local area for both health support, education and leisure. Staff understood the diversity of people’s needs and ages in supporting them to look at different opportunities. A member of the management team told us, “We are always looking for different opportunities which will support individuals in having a meaningful life. That is our aim.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s communication needs were known to staff. This included understanding where people may need more time to process information or how to respond when people appeared confused. One person told us they preferred information to be displayed so they could refer to it at different times as a reminder. We saw this was in place to support the person’s routine. Staff told us they understood the need to ensure people’s personal information was kept confidential to them.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. We observed staff taking time to speak to people and check they had understood the conversation. Meetings were held with people regularly to discuss if they were happy with their support and action was taken where they wanted changes. One person told us they had been unhappy with where they were living previously and wanted to move somewhere quieter. The provider had supported them with this move, and they were now settled in their new home. They told us this had made a big difference to them, and they now felt much calmer.

We observed where complaints had been made by people or relatives these were responded to in a timely way and in line with the provider’s policy.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The provider and manager told us people’s support was provided in a way which respected their dignity, choices and rights. This included supporting people to access appointments and maintain contact with different services to support their mental health needs and wellbeing. However, contact with some professionals indicated the support people received to access support could at times be more open and responsive.

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. People’s diverse needs were known to staff and respected. People were encouraged to express their individuality in ways of their choosing. Staff told us they were aware that due to some people’s needs they may experience discrimination when out and were alert to this happening. They told us, “As the carer you make sure this doesn’t happen. You communicate and look for risks that may make them anxious or upset.”

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future. People were supported to plan for the future and their aspirations were recorded. One person told us what they hoped to do as a career in the future and felt staff were supporting them to plan for this. No people currently using the service were receiving end-of-life care. The provider had an end-of-life policy and procedures which would guide staff in the event of this being necessary.