CareCaliRaya Ltd T/A Apollo Care South Liverpool

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 newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met.

The provider was in breach of legal regulation in relation to people’s safe care and treatment.

This service scored 50 (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 involved people in the planning of their care however, care planning records did not always show how they worked in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Where the provider had completed care plans, we found these were person centred and contained detailed information regarding people's preferences and likes and dislikes. However, we found many care plans relevant to people’s needs had not been completed. This meant there was a risk people would not be cared for in the way they needed or preferred. Information on people’s individual risks and how they impacted on the person’s safety and personalised care required improvement.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities. Care records did not always evidence how care was joined-up, flexible or supportive of choice and continuity.

People lived with a range of health support needs, not all these needs were recognised and recorded within care plans. Where these needs were recorded, the associated risks and joined-up approach to meet those needs from working with other professionals, was not always in place. For example, we identified the provider failed to take action to source necessary training and information on care interventions from the local drug service prior to them commencing care for a person with these needs.

The provider did not always have an effective system in place to ensure continuity was maximised. Although people had regular visits, the registered manager confirmed they did not have a continuity aim for how many staff would visit each person to better promote familiarity and positive relationships built on trust. We received mixed feedback from people regarding the consistency of their staff teams, with some people telling us they saw too many different staff. A relative told us, “Consistency is key with dementia, we see too many faces which is confusing for [Person].”

The registered manager was able to demonstrate effective working relationships with other professionals in support of people’s end of life care and support needs.

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

Staff accessed people’s care plans and shared information about people’s daily care using handheld devices which linked to the provider’s electronic care planning system. We found several care plans were either missing or did not provide enough information to effectively guide staff to deliver effective care.

The provider did not always ensure detailed communication plans were in place for people with sensory and communication needs. For example, a communication plan did not fully consider the impact of the person’s sensory loss or provide guidance for staff on effective ways to engage with them. The absence of detailed communication plans increased the risk of unmet needs and inconsistent care.

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.

The provider had a complaints policy, and we found an effective system was in place to review and respond to complaints.

Overall, people and their relatives told us they were involved in care planning discussions, had regular reviews and were sent surveys to seek their views on their experience of the care provided. They told us they felt confident any concerns they had would be resolved. A relative told us, “Their commitment is amazing, it’s not completely without fault, there are occasions thing goes wrong but they acknowledge it and rectify it, and we have open communication.” A person told us, “I don’t have any issues, but I am certain any issues I had would be resolved.”

The registered manager and staff were knowledgeable about people’s needs and any changes in their care. Records showed regular reviews had taken place, but information about what was discussed at the reviews was not always evident. We shared our findings with the registered manager and discussed the importance of keeping accurate records regarding discussions about people’s care and support.

The provider did not always make sure people could access the care, support and treatment they needed when they needed it. Once a referral was received, the provider did not always follow their preadmission process to ensure people received assessment in a timely manner. For example, when input was required from the local drug service, we identified the provider did not contact the service in a timely manner to gather information about risks and arrange essential safety training for staff.

For people receiving care at the end of their lives, we found the provider worked in close partnership with community nursing teams and escalated concerns accordingly. We received positive feedback from external health professionals in this area. Comments included, “Staff will liaise with senior nurses with any significant updates that will need to be reflected in the care plan and care needs of the patient."

Staff and leaders did not always actively listen to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Overall, people’s experience of care was positive. People and relatives felt the support met theirs or their loved one’s needs. However, care plans and risk assessment lacked the essential detail required to meet people’s needs. This increased the risk of people’s outcomes not being consistently met.

Where the provider was commissioned to support people with activities, we saw people had choice and control over this and took part in activities that mattered to them.

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. People’s care plans had a section relating to end of life care but in most cases, these were either blank or not sufficiently detailed with people’s end of life care wishes.

The providers training records did not evidence staff had completed end of life training. Most staff we spoke with had experience of supporting people at that important stage in people’s lives. They were able to tell us the important aspects of care for people towards the end of their lives. A staff member told us, “When they are in their last days, I make sure they are comfortable and monitor them reporting any concerns to the district nurses, we’re not just there for clients but we are there for families as well as they are going through a hard time.”

We shared our findings with the registered manager who developed an action plan to improve the quality of people’s care plans.