The Care Bureau- Home 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 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.

A relative said staff were responsive to meet individual needs. One relative said how their family member benefitted from routine and being supported to go out. This relative told us their family member had a consistent staff team, who arrived on time and did the things the person wanted. This relative said this helped managed their anxieties, saying, “[Relative name] has a perching stool to help with washing up which they like. Staff help sit her on the floor and pull up weeds; they love gardening.” This relative said the persons independence was supported, and staff were able to react in the moment to do what was needed. Another relative said how well staff worked to respond and identify the potential onset of a seizure and what was needed, pre and post seizure. to keep their family member safe. Information in the person’s care plan prompted staff to look for potential triggers so they could be best prepared.

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.

The provider liaised with other health and social care professionals to promote continuity of care. In 1 example, a relative told us they and staff attended care reviews and had meetings with social services to ensure the support remained relevant. There was input from speech and language therapists which helped the person write a communication book, as well as supporting the person and staff, with modified diets and fluids to help reduce the risk of aspiration. One relative said if they were unable to take their relative to an appointment, staff would help.

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

People’s information formed an electronic record for staff and the provider, whilst people had a written copy, with other available provider literature in written form. In 1 example, a person used a communication book to help communicate their choices, feelings and preferences. However, we spoke with the deputy manager and registered manager who told us they supported a person who was blind. Some of the providers documents said this could be available in Braille, so we asked them if they had asked this person. Neither manager had, even though some paperwork said they could be adapted. They also confirmed to us; easy read or pictorial information was not readily available or had been considered. Their responses showed this was the responsibility of the person or family member to request, rather than the care team being proactive. We recommended they offered choices for adaptation in future to best support some people’s needs and the registered manager assured us this would be done.

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 registered manager was confident people, and their families had opportunity to share feedback or raise any concerns. The registered manager said, “We are such a small team so we all know each other really well, we can say what we need to.” Observed practice and spot checks of staff’s practice and competency provided opportunities for people and families to share feedback with senior staff. People and relatives knew who to contact if they had concerns.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

New people to the service were signposted to other healthcare professionals to support their ongoing health needs. This included local GP practices, as well as other health professionals such a speech and language therapists. For people who had been with the service for a while, they were also supported to seek external health support where needed. Staff understood which services to call if people needed medical support or guidance. Members of the management team were available on call to provide guidance and support in an emergency. Following our recommendation about covert medicines, the registered manager contacted the person’s GP and pharmacy to get the right information they needed.

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.

Staff said they completed equality and diversity training, as well as training specifically related to autism and learning disabilities. This provided learning to staff to ensure they understood their responsibility to support people without discrimination and to protect people’s characteristics under the Equality Act. Staff told us they would feel confident to speak up if they felt people were not receiving the care they needed to achieve positive outcomes. The registered manager said there was an internal whistle blowing telephone number staff could call anonymously to report concerns.

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.

At the time of our visit no one was receiving end of life care. The registered manager said they had previously supported people at end of life. They explained how they involved the person and their family members to provide the end-of-life care the person wanted. The registered manager said an end-of-life care plan would be put in place and amended in line with the person’s wishes, at the time and considering, any future wishes.

To support people to make plans for their immediate care needs, plans for people were made responding to the here and now. Some of those plans were focussed on supporting people to achieve longer terms goals. For example, 1 person told us they had anxieties and on occasions found it more difficult to undertake washing dishes. The person told us staff were supporting them to look at purchasing a dishwasher which would help; however, staff were mindful they did not want to take away the person’s independence. The conversation with this person showed they were involved in those important conversations and how those decisions may have an impact on the future.