Altogether Care - Care At Home Limited Salisbury

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 64 (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 decide, in partnership with people, how to respond to any relevant changes in people’s needs.

People did not always receive care that met their needs and preferences. People raised concerns about having multiple carers: “was not person centred” and “I have telephoned the office about late visits, and they are sympathetic but nothing really ever changes”. Other people told us they had to contact the provider daily to find out who their carer was as this “often did not reflect the rota they have been sent”. People told us that delays affected their daily routines and independence. Comments included “Sometimes my relative who is bed bound is left in wet bedding” and “I rely on carers to help me get out of bed, and when they’re late, it’s really hard.” Despite the timing of visits and consistency of staff, feedback in other areas of person-centredness was positive.

During the assessment, the provider shared some examples of person-centred care. This demonstrated they were committed to supporting people in a holistic way. For example, one person was supported to access days out which interested them. The person told us “My carer takes time to get to know my likes and dislikes”. They told us the impact of this was that having the carer participate was more like an extension of their friend circle.

The provider understood the diverse health and care needs of people and their local communities. Care was joined-up, flexible and supported choice and continuity.

Staff and leaders kept professionals up to date with any concerning information about a person’s wellbeing. They were also invited to care reviews, which enabled coordinated and improved support for people. This meant professionals supporting the person had accurate, up‑to‑date information, and everyone involved in their care could work together effectively to make sure the person received the right support at the right time.

Leaders were knowledgeable about people’s diverse health and social care needs. They gave examples of these and explained how other professionals were involved to ensure the person’s wellbeing. For example, managers described one person “whose health fluctuated”. They said they regularly liaised with other professionals about this, to ensure the most appropriate support was being provided.

People told us the service worked well with other professionals when needed. This included local GP surgeries, the local authority safeguarding team, social workers and pharmacies.

The provider ensured people and their relatives had access to clear, timely and accessible information about their care and support.

Reviews were routinely completed with people, giving them opportunities to discuss their support and raise any concerns. The manager liaised with commissioners and stakeholders to ensure people received regular service reviews, and that any changes were communicated promptly.

To make information accessible, the provider had an easy-read complaints policy available for people. This explained how to raise issues in a format that was tailored to people’s needs. Staff confirmed they explained any changes in care plans to people and their families, ensuring transparency and involvement in decision-making.

This proactive and inclusive approach meant people and families were well-informed, empowered to make decisions, and reassured about the quality and continuity of their care.

Care plans contained detailed information about people, and this was filtered through to people’s risk assessments. This meant staff had access to up‑to‑date guidance that helped them understand people’s individual needs, preferences and potential risks. As a result, staff were better equipped to provide safe support. They responded consistently to early signs of deterioration and had the information to support people with informed decisions that promoted wellbeing and independence.

The provider made it easy for people to discuss and update their support, feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them of any changes.

The provider completed care reviews with people to give them opportunity to discuss their support. People told us: “If I need anything I just let them know, I can’t remember anyone saying no to anything I ask for” and “Staff listen to me and are great – I requested female only support and Altogether care couldn’t have done more, I only needed to ask once”.

People told us “‘If I had any concerns, I would raise it with the manager” and that if they were not happy, they would tell staff. The provider had a complaints policy in place. This meant complaints would be investigated and a response provided to the person.

However, some people told us they did not feel listened to when they had raised issues regarding the timings or consistency of visits. 8 out of 12 people had told us they were unhappy with this aspect of care from the provider. The provider did not audit visit times. We spoke to the provider about this who assured us they would investigate these concerns. Despite this, everyone we spoke to told us they would recommend the provider and that they were listened to regarding every other aspect of their care.

The provider made sure that people could access the care, support and treatment they needed when they needed it. For example, the provider worked with several people and their relatives to ensure they had care at different times, dependent on their needs. With this joined up working approach, the person was able to enjoy a life that was free from barriers and which offered tailored support. The impact on the person was that they enjoyed accessing the community and spending time away from carers.

Assessments covering the accessibility of a person’s home and whether any adaptations, equipment or referrals were needed had been completed. The provider ensured that as well as people having access to services such as adult social care practitioners, family members also had equal access to requesting support from other organisations such as alcoholics anonymous.

The provider worked to ensure people and their relatives received a fair and equitable service from stakeholders. Hospitals were challenged by the provider when discharge plans had not been completed. This meant people were safer when returning to their homes because staff had information that enabled them to provide the best support.

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.

Staff had completed equality and diversity training and respected each person as an individual. For example, one person was informed of health implications following changes to their physical health. The provider ensured new care plans were created which were centred around the person’s changed needs. The provider actively sought input from external stakeholders and organisations to maintain continuity and follow-up, so the person’s needs were fully met.

People told us they were supported to access services to meet their healthcare needs. Comments included “The carers will take the lead if I am not feeling confident about expressing my needs”. This meant people felt assured their day‑to‑day health needs were managed well, and they had fair access to important treatments and appointments.

Policies included guidance on reasonable adjustments, preventing discrimination, and supporting people with protected characteristics. Staff told us “I am given shifts which fit around my need to take public transport as I am a non-driver” and “The provider has supported me to learn how to drive”. Leaders told us “When planning care visits, we assess all staff on an individual basis”. This meant staff were supported fairly and consistently, with adjustments made so everyone had an equal chance to do their job well. It also showed the provider considered individual circumstances when organising work, helping to create an inclusive environment where staff felt valued and treated with respect.

The provider provided information packs to people who were on work sponsored visas. We saw cultural packs explaining how British customs were important to people receiving care and support.

People were not always supported to plan for important life changes. This did not always allow them enough time to make informed decisions about their future, including at the end of their life.

The provider had put some end‑of‑life care planning documents in place, but these were not always comprehensively completed. For example, several care plans did not record the person’s preferences or decisions about their end‑of‑life care, which could impact on people being supported in relation to significant life changes. Comments included: “I do not know if staff know what my wishes are”. This meant people were not always able to make informed choices about their future care, and staff did not have the information they needed to support people in the way they would want at the end of their life. Important wishes may have been missed, increasing the risk that people’s final stages of life would not reflect what mattered most to them or their families.

However, all staff had completed training in end‑of‑life care. This meant they had the knowledge and confidence to support people with dignity, recognise changes in their condition, and follow best‑practice approaches during the final stages of life.