PHH Care Ltd

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 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.

People and their relatives spoke positively about the support they received. They told us, staff responded flexibly to their needs, one relative told us, “They give [person] three showers a week but do extra if necessary.”

Staff adjusted their communication methods to meet people's individual needs. For example, 1 person preferred not to wear their hearing aids, staff used pen and paper to communicate effectively with them. This helped to ensure the person remained involved in decisions about their care and was able to express their wishes and preferences.

Care records included positive information about the importance of family relationships. Staff encouraged conversation and social interaction whilst recognising when people were tired and required rest, demonstrating a personalised and responsive approach to care.

Care plans provided information about how people preferred their personal care to be delivered, including the equipment required and the areas they could wash independently.

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.

People told us of shortfalls regarding continuity of care, we heard, “There's no consistency of carers.” A lack of continuity meant some people were supported by a larger number of different staff, which could impact relationship-building and continuity of care.

There were gaps in people’s daily care records, including missing entries for visits. Incomplete records reduced assurance that important information was consistently communicated between staff and could impact the provider's ability to deliver coordinated and responsive care. The provider had identified this and addressed this with staff.

People generally spoke positively about the service and told us staff usually arrived on time for scheduled visits, staff contacted them in advance if they were running late, which helped to reduce anxiety enabling them to plan their day. However, this was not consistent across the service. We also heard, “They [staff] make a few mistakes. Sometimes they're late and there's no contact.”

The provider supplied information in formats tailored to people's individual communication needs and had considered how people accessed and understood information about their care and treatment.

People's communication needs were identified, recorded and shared with staff to support the delivery of person-centred care. Individual communication preferences were considered as part of care planning and reviewed as part of ongoing support, in line with the Accessible Information Standard.

Care records contained information describing how people communicated, as well as approaches staff should use to support effective engagement, including details of people's preferred methods of communication, adjustments required to ensure people could understand information and express their views and choices.

Staff demonstrated a good understanding of people's communication needs and were able to adapt their approach accordingly.

The provider made it easy for people and their relatives to share feedback, raise concerns and make complaints about the care and support they received. There were systems in place to receive, investigate and respond to complaints, and people were generally aware of how to raise concerns if needed.

People and their relatives told us, they knew there was a care plan in place and understood that staff used an electronic system to record their visits.

People did not raise significant concerns about their care. Staff involved people in decisions about their care and support, using daily care records to communicate information about visits and ongoing support.

The provider had systems for managing complaints. Complaints had been investigated and actions were followed up to address concerns and support improvements. However, records were not always sufficiently detailed to demonstrate how concerns had been addressed as records did not always contain evidence of the actions taken or demonstrate how outcomes had been communicated and monitored.

This meant the provider could not always evidence that learning had been fully embedded following concerns raised.

The provider did not always ensure people were able to access care, support and treatment in a coordinated way when they needed it. Staff sought support from healthcare professionals however, communication with external services was not always consistently documented.

Staff recognised changes in people's health and wellbeing and, in some cases, appropriately contacted relevant healthcare professionals for advice and support. This helped to ensure people had access to specialist input when required. However, records did not always evidence that concerns had been shared with relevant professionals in a timely manner.

For example, where staff were aware of changes to people’s needs, they had not communicated these to visiting professionals. Similarly, a person’s recent falls was not discussed with the falls team during a visit, despite being relevant information which may have required further assessment and support.

These omissions meant the provider could not always demonstrate that important information about people's changing needs had been effectively shared with external professionals. This reduced assurance that people were consistently receiving coordinated care and timely access to specialist support when required.

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 and their relatives told us, staff knew them well and provided care that was responsive to their individual needs. Staff listened to people and acted on information shared with them to promote comfort, dignity and independence.

Staff and leaders demonstrated an understanding of people's individual needs and adapted care and support to promote positive experiences. Staff listened to people and those important to them and responded to their preferences, communication needs and personal circumstances.

People were not always supported to plan for important life changes, including the end of their life, to ensure their wishes, preferences and decisions were understood and respected.

The service supported people approaching the end of their lives, details of support required were not always sufficiently detailed or person-centred.

Care records contained limited information about people's wishes, preferences, beliefs or choices regarding their future care and treatment should their health deteriorate. In most cases, information available was a general instruction to keep the person comfortable. This did not provide staff with sufficient guidance to ensure care was delivered in line with the person's individual wishes and preferences.

The absence of detailed end of life planning meant there was limited evidence people had been supported to consider and discuss important decisions about their future care. This reduced assurance that people's preferences would be known and consistently respected during periods of deterioration or at the end of their life.