Homecare Solutions For You

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 service. This key question has been rated Requires improvement.

Requires Improvement: This meant people’s needs were not always met.

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.

Care plans and care notes were not consistently person-centred. Documentation did not always reflect people's current needs or risks, including changes to medicines and mobility. Incident recording was inconsistent, and in some cases, information was missing or outdated. Although all individuals had a care plan in place, these were not always accurate or detailed enough to guide staff effectively.

During this inspection, the provider acknowledged these shortfalls and began updating records: however, these issues had not been identified through their own quality monitoring system.

We received mixed feedback regarding access to care plans. Some people had paper copies available to them, whilst others reported they could not access their care plans as they were held online.

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.

There were inconsistencies in how care was coordinated and reflected in people's care plans. For example, some care plans required clearer guidance regarding family support and care staff responsibilities.

People told us they received support from regular care staff and that care staff were consistent and respectful and willing to stay longer when needed. One person told us, “(Relative) is never rushed and the carers have regularly spent more time than they should with (relative)so as not to stress them out “. Another said, “I have regular carers, they are all very nice and they do all they can to look after me well, they are respectful and I think they do care about me”

However, improvements were required to ensure reviews were completed regularly and updates were accurately recorded in people's care plans.

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

Information was not always accessible or fully adapted to people's needs. Care plans were not currently available in people's first language, although the provider told us they planned to translate key documents, including care plans and the service user guide. The complaints policy for most people had already been translated to their first language.

Pre assessment documents were completed; however important information was not consistently transferred over. The service user guide included relevant fee information but had not been fully tailored to the service. For example, sections contained template wording that did not apply, such as references to external representatives or specific names.

Despite gaps in written information, people told us staff communicated well with them. Carers were matched where possible by language, which supported people to understand their care.

One relative told us, “Both of the carers speak Gujarati this is my (relative) native language, when we started with the service were told that, if possible, the company would try and get carers who understood or spoke it as it happens we were very lucky."

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 sought feedback through quarterly feedback forms and text messages, and people told us they knew how to raise concerns. One person told us, “I am aware of how to make a complaint but unless anything changes, I will not need it”. Another said, “I have never had a reason to complain but I would have no problems doing so if I needed to". A complaints policy was in place. However, a complaint we reviewed, although addressed promptly, had not been managed in line with the provider's own policy. This meant processes for learning from and responding to concerns were not always followed consistently.

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

The service user guide included out-of-hours contact information. However, staff were unable to access the on-call rota directly, despite the policy stating they would have access to it. The provider told us staff identify who is on call by ringing the on-call number. The management team confirmed staff could contact emergency services and use the on-call system if required.

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

Staff had completed training in equality, diversity and inclusion and people and their relatives did not report any concerns about unequal treatment. However, care plans did not always reflect people's current needs, which created a risk of inconsistent experience. The provider recognised these gaps and had begun taking steps during this assessment to improve documentation.

The service had appropriate policies in place, including safeguarding, complaints, lone-working and equality and diversity. However, some contained conflicting information and were not consistently followed, which limited their effectiveness in guiding staff practice.

People were not 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.

Advanced wishes were not currently discussed as part of care planning, when this was discussed with the management team, they assured us this would be introduced going forward. An end-of-life policy was in place and staff had completed relevant training. However, people's care plans were not always clear regarding DNACPR arrangements, this created a risk of important information not being consistently communicated. The people we spoke with told us that they had been asked about DNACPR. One person told us, “Yes my (relative) does have a DNR but I am not sure if the carers know about this, it is stated in their care plan which was discussed and completed with me, my (relative) was present.”