Becoming Care Services Limited

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.

This service scored 61 (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.

People’s care plans lacked detail and information to help ensure that a staff member who may not know the person would have sufficient detail to enable them to provide person-centred care. It was unclear in some people’s care plans the reason for them needing support, and in others, there were statements such as, ‘to have my likes, dislikes, and dietary preferences respected’ but without any further detail. Without this information, staff would not know what this person’s preferences were.

Other information was generic, lacking detail, or was not individualised. For example, ‘apply creams if prescribed to maintain good skin integrity and reduce risk of breakdown’ and ‘provide a drink to take medication’. These sentences were included in all the care plans we reviewed, and again, no further details were provided. This meant people’s creams may not be applied correctly and as such affect people’s skin integrity.

Management knew people, however, as we heard the provider talk about 1 person saying, “He loves flowers. He will tell you all the names of the flowers. He loves tennis and flowers” and yet this level of detail was not recorded in the person’s care plan.

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.

The registered manager tried to ensure that people received care from the same staff group, and records indicated this happened. However, the registered manager said timekeeping was an issue. This meant that although people got to know staff, there was a lack of continuity in the timing of care calls, and as such, people told us they did not always know when staff were due to arrive with 1 person told us that they were not always warned that a staff member may be late.

Care plans included information about involvement from family members, including legal arrangements such as a lasting power of attorney.

Staff had undertaken a range of training, including dementia and other conditions, which supported their understanding of different health needs.

The provider supplied up-to-date information in formats that were tailored to individual needs.

Prior to a person starting to receive care from the service, they were provided with an information pack and details of the complaints policy. This helped ensure that people had all the information they required about the service and knew how to raise a concern or complaint should they have one. A person told us, “I have a contact number for a member of the management team, and they are very responsive and helpful.”

Each person signed a care contract, which set out the arrangements for their care calls and the costs involved, which demonstrated a transparent approach by management.

People were able 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 and registered manager provided care to people themselves, which enabled them to get to know people and check with people if they were happy with the care. The registered manager told us, “We have not had any complaints, although people can be unhappy with the lateness of staff at times. This can happen when the drivers are stuck in traffic, as it is a very busy area where we are providing care. We do phone people to let them know, however. The director and I split our visits to people, and we will also drive the staff around. This helps us stay in contact with people and lets them know they can speak to us if they wish to.”

A person told us, “There was a form I had to fill in about the care company. It was a feedback form about the staff and whether they were friendly and good at delivering care.”

People were supported to access the care, support and treatment they needed when they needed it.

The registered manager told us, “Because people are in their own homes, we try to give them more support to remain independent. We ask them what they feel, so they are part of the care that they need. We will contact the GP or another health professional on their behalf if they need it.”

People told us staff supported them when needed in relation to hospital or medical appointments. One person told us, “We will discuss everything together and will be prepared for any appointment coming up. She is brilliant.”

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.

Although the registered manager told us, “We keep the same group of staff going to people. We look at staff personalities, interests and capabilities when doing an assessment so we can match staff with people” there was little evidence to demonstrate the service recorded this information about people.

People’s care plans lacked detail of their life history, information about their preferences, likes or dislikes and guidance for staff on how they liked to spend their time. This was despite the registered manager telling us, “They (people) tell staff their history.” Without this information, staff may not know when a person may be at risk of experiencing inequality and, as such, support them appropriately. One person told us, “My personal history/background/hobbies were not discussed.”

However, we did hear that staff used people’s preferred names. This included where 1 person who wished to be known formally to staff resulting from how they were known when they worked.

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 lives.

Although no one receiving care from the service was at the end of their life, there was little or no information about a person’s wishes recorded in their care plans. The registered manager told us, “We usually leave this to the GP and sometimes we talk to the family. We do have the DNAR (do not resuscitate) in place.” This meant if people reached this stage of their life and were unable to communicate, staff may not have sufficient detail available to them to ensure they provided the most relevant care.