Archived: Independent Options Central Support Service

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 Requires Improvement.

This meant people’s needs were not always met.

This service scored 43 (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 work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Staff were well-intentioned towards people. However, they did not always recognise people’s individual needs or know how to meet these. People and their representatives were not always involved in decision making about people’s care and treatment. One relative told us, “There were changes in my loved one’s medicines and their routine, but I wasn’t told about it.”

People’s care plans were not sufficiently detailed to enable staff to provide good level of care to people.

Some care plans had missing or contradictory information and this puts people at potential risk of not receiving safe care.

Care plans did not consistently demonstrate the involvement of people or their families in the planning of their care.

Records made about people were task focused and lacked information of how people’s emotional and social needs were met.

People did not always have access to meaningful activities or engagement. We observed people spending time on their own with little or no engagement from staff.

We received mixed feedback from people’s relatives regarding people’s engagement. One relative told us, “My relative is bored and rings me all the time. I have to ring staff and tell them what he is telling me over the phone.” Another relative told us, “Yes, they do what they can, going out and about. We did try for a day centre but there is no funding, so they do struggle sometimes.” One stakeholder told us, ”Due to staff shortages and management failings, people experience fewer opportunities for community engagement, negatively affecting quality of life.”

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’s records did not always demonstrate consistent contact with professionals. People’s relatives told us sometimes they had to instigate contact with professionals instead of staff. One relative told us, “I asked for a medicines review for my loved one, and the manager refused. I had to contact the doctor myself.” Another relative told us, “My loved one didn’t have adequate medicines, and they would have run out no matter what. They did sort it out but If I hadn’t said anything I don’t know if they would have noticed.”

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

There was very little information in people’s care plans regarding communication needs and how to meet these needs for people.

Information was not always presented in a way that was meeting people’s needs and that supported their understanding. We saw some care plans were provided in an accessible format. However, we were not assured that these were updated regularly to ensure they were appropriate and met people’s individual needs.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

People and their representatives were not always provided with opportunities to share feedback and views regarding care and support. One relative told us, “We would like to know more and be involved.” Another relative told us, “I’m not sure they would tell us things because communication has been so bad. I think they would keep it within and not tell us. If they want to know something specific, they will phone me but we don’t hear from them very often.”

People’s relatives knew who to contact and speak to if required. However, they felt they would not always be listened to. Some relatives told us they would be reluctant to speak and raise concerns as this might impact on care and support people receive from staff. One relative told us, “We can’t say anything to the staff without it having impact on the care my loved one receives. Staff will ignore us or treat us differently if they know we have spoken to the management about them.”

Relatives also expressed their concerns regarding speaking and raising concerns directly with the management. One relative told us, “I can’t speak to the manager as they take things personally.” Another relative said, “If we had stable team and could say things without it impacting on my loved one this would be better.”

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

People’s records were not always clear about the support and advice they received from professionals and that they had access to additional services when it was needed. We saw some people accessed services such as Speech and Therapist (SALT); however, people’s needs were not always reviewed to make sure that advice was still current and relevant to their needs.

People’s relatives told us, they had to instigate contact with professionals, for example, regarding people’s medicines or health issues and the support their loved ones needed when attending appointments. One relative told us,” We have to do appointments for my loved one because they have been short staffed especially in the morning.”

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

People were not always enabled and supported to share their feedback and their views. There was no evidence how feedback was gathered from people who may need support and additional aids to communicate their needs and wishes. One relative told us, “My loved one is less able to voice their needs to staff than some, so they are struggling.”

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 records were not clear regarding their future treatment they may require and their wishes regarding this. This included people’s care plans.

There was no end-of life training available to staff.

There were no people receiving end of life care at the time of our assessment.