Chadcome Healthcare Limited

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• 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 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 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 received person-centred care by staff who knew them well. Staff described people’s preferred routines, personalities and relationships in detail. For example, what toiletries people liked to use and how they liked their breakfasts to be laid out. A person had hearing difficulties and staff gave examples of how they ensured good communication. However, these techniques were not documented. We discussed with the provider that records did not contain person-centred information, they told us they would review this as a priority as new staff were due to join the team and would not know this level of detail.

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 by a consistent staffing team. A relative said, “For [person] to still have the same carers, I see this is very good. They have had the same carers since we have used them.” Staff completed training courses to ensure their knowledge and skills were relevant to the people they supported.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The nominated individual told us documents could be made available in formats to suit people’s accessibility needs. These included easy read, larger print and audio versions.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. The provider had a process in place to address and learn from complaints. However, there were no processes to routinely obtain formal feedback from people and their relatives. The provider shared some positive reviews they had received on a care review website, though the questions asked were not specific to the service provided. People were supported by the management team and had opportunities to speak up or complain if needed. A person told us, “Feedback hasn’t formally been asked but during the calls they check I am satisfied.” A relative described an improvement suggestion they had made to the management team and told us they had been listened to. Cards with thank you messages from people and relatives had been sent to the provider which they shared with staff.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People’s visits were scheduled at a time to suit them; people gave examples of when they have rescheduled visits to suit their social lives or medical appointments. The provider had adjusted the duration and frequency of people’s visits in response to their needs and preferences. A person told us, “I chose them as they were more flexible and don’t over charge like some of the others.” People and staff were able to contact the management team when needed through the on-call system. A person said, “They do answer the phone when I call.”

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. Care plans and assessments provided an opportunity for staff to consider and document if people were at potential risk of barriers to healthcare outcomes. The nominated individual shared that the people they supported were able to access health and care professional advice themselves or with the help of their family members. They gave a recent example of liaising with the pharmacy regarding a person’s prescription. Staff contacted people’s relatives with their consent if they had any concerns. A relative told us, “They contact us if [person] is not right, they suffer from swollen ankles and had some water tablets for about a week which worked well. They (staff) informed me when the medication came, a couple of mornings [person] had some dizzy spells where staff came and they let us know. One occasion last year they called careline who checked [person] over.”

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. Sections of people’s end of life care plans had not been completed. The nominated individual told us these discussions had not taken place; however, they would approach the subject sensitively with people, if appropriate, at their next review. They said a person had spoken openly about their wishes for their future planning but this had not been documented. Care plans did contain details of whether a person wished to be resuscitated or not and staff had received training on the practicalities of supporting people at the end of their lives.