Affinity Trust- Domiciliary Care Agency- Central

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 71 (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 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. People’s care plans supported staff to be aware of people’s individual needs and social histories which helped them to understand the person and deliver the right care and support. People’s care records focused on how they wanted their care to be provided, what the person could do for themselves and where assistance from staff was needed. Care records showed people’s voice was at the heart of the care provided. For example, care plans detailed what was important for the person, including maintaining relationships or developing independence to move into their own home. We received varied feedback from people and their relatives around the personalised care staff provided. Where people received care from an established and consistent staff team, comments were positive. A person told us, “The staff are pretty good. They know me well. They listen to me and know what I like. We have good banter, but not with the agency staff” A second person told us, “I have lived here long enough for the staff to know my likes and dislikes. If I didn’t like anything they did, I would tell them. ”Where people experienced staffing changes or use of temporary staff, people and relatives felt this impacted on personalised approaches. Comments included, “Some staff are excellent, and the others are a nightmare. They clean but don’t really seem to care,“ If [Name] is in crisis, the staff team don’t seem to understand. I have to speak to the manager to tell the staff to listen to what [Name] needs” and “I would describe staff consistency as fair to middling.” The registered manager was aware of concerns around staff approaches and consistency and had implemented recruitment processes and improved induction standards to address these. These improvements were not embedded at the time of our inspection visit.

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’s care plans included information about their diverse needs. Staff had received training in people’s diverse needs including equality and diversity, dementia, learning disability, mental health and autism. Staff understood the needs of autistic people and people with a learning disability and worked hard to ensure that typical barriers faced by people were removed or mitigated against. They recognised when people were at risk from poorer experiences and worked to ensure everyone was included and provided advocacy where needed. For example, staff worked with health professionals to make adaptations and use flexible approaches to enable people to access medical appointments and healthcare where this was a trigger for people’s distress.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s care plans included information around their preferences for communication and how information should be shared with them. Guidance included environmental issues, such as giving information in a quiet area, limiting the volume of information people received and giving them time to process it. A staff member told us, “We get to know people well and to understand what they need to be able to communicate and understand information. For example, we noticed [Name] responds better if they have something in their hands that is tactile and sensory. This seems to give them confidence to communicate and interact. ”We saw staff shared information in a variety of ways including gestures and objects of reference. A relative felt some staff were not trained in the use of Makaton (a language system using signs, symbols and speech). The registered manager had recognised this and was in the process of implementing training for staff.

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. There was a complaints procedure in place and concerns and complaints were being acted on and used to improve the service. People and relatives told us they knew how to raise a concern or formal complaint, and they were confident they would be listened to. People’s comments included, “If I was worried, I would speak to staff. They listen to me” and “Staff are pretty good. If I have any worries, I would speak to the (community) practice nurse or the manager.” Relatives told us they felt involved in their family member’s care. One relative told us, “I have no concerns around care planning. The staff always let us know what is happening, including health appointments.”

The provider made sure that people could access the care, support and treatment they needed when they needed it. Staff had good working relationships with local health professionals and knew how to contact the appropriate teams to support people when the need arose. Staff were quick to respond to changes in people’s needs and support people to contact routine and specialist services when required. Staff worked with health professionals to understand people’s tolerances and experiences to enable them to access routine and specialist services. Staff told us, where required, people had advocates who ensured people’s views and wishes were represented in all aspects of their care.

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 were supported to access community resources and services. A person told us, “I have sight loss; the staff are always with me, and we go out as this is important to me. They help me go to the shops, the pubs and to bingo– we go out a lot!” A staff member told us, “We worked with the local barbers and shops so that they understood [Name]. Now [Name] is able to go out when it’s quiet as they don’t like noise and crowds. They wave at the barbers each morning; it feels like they are part of their community now.”

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 plans showed people and those important to them were given the opportunity to discuss their end of life wishes and care plans reflected their wishes where they had made decisions. People’s care plans reflected planning for their future life development, with short term goals and a progression towards longer term aspirations.For example, where people were planning for more independent living, staff ensured their goals and outcomes reflected this and they were supported to work towards achieving their future ambitions.