East Hampshire DCA

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.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person-centred care, mental capacity and planning for the future.

This service scored 57 (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.

People’s views, opinions and choices were not consistently captured or translated into plans which supported them to be in control of their lives.

Care records showed limited evidence of personalised goals, future planning or ambitions such as learning new skills and developing independence.

Daily care records lacked detail, which limited assurance that people were developing independence or leading meaningful lives.

Care was not always fully joined‑up, flexible, or supportive of choice and continuity. Although the service worked with other professionals, feedback from relatives was mixed regarding how effective this coordination was in practice.

Daily records did not clearly show whether people received their assessed and funded one-to- one hours. Activity planners, keyworker notes and staff rotas did not always clearly identify when one-to-one time was scheduled or delivered, meaning the provider could not clearly evidence that people received their agreed funded support. A relative told us, “She used to get more hours. Now they are mostly for making beds, cooking meals, teeth. Not many people doing activities, only going out twice a week. Sitting in the flat is not ideal.” This feedback reflected the gaps we found in planning and recording of meaningful engagement. However, one person had recently had their funded hours increased in response to changing needs, which was a positive development.

The service had recently achieved a more consistent staff team, which had begun to improve continuity of care.

The provider did not consistently ensure that information was accessible or tailored to people’s individual communication needs. Tenancy agreements and meal plans were provided only in written format, and not in a format all people could understand. Some accessible materials were available, such as easy-read versions of the complaint’s procedure and information on menopause.

Some people benefited from visual aids, including pictures on wardrobes and doors to indicate contents, and one person used pictorial breathing‑technique prompts to support emotional regulation. The registered manager had begun introducing picture cards specifically to support people in understanding and choosing activities; however, this approach was still in the early stages and not yet fully embedded across the service.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

Key worker meetings were taking place; however, there was limited evidence people were actively involved in these discussions, or their views influenced their care and support. Meetings for people using the service had ceased, reducing opportunities for people to express their views collectively. The registered manager told us they planned to reintroduce these meetings to improve involvement.

We received mixed feedback from relatives about the opportunities they had to be involved in their family member’s care and support. Some felt informed and engaged, while others reported limited communication or input into planning.

There was a complaints procedure in place, including an easy‑read version. This indicated the provider had taken measures to ensure people could raise concerns in a format they understood.

The lack of consistent and meaningful involvement meant people were not always empowered to influence their care, and the service missed opportunities to learn from feedback and improve people’s experiences.

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

Staff supported people to overcome barriers to ensure they could attend and engage in healthcare appointments and supported them to follow up on advice or treatment plans. Where one person had a phobia of lifts, the health professional visited them at home. These processes supported people to stay healthy and receive timely care from professionals, reducing any barriers to access.

Suitable staffing levels to meet the needs of the people at the service were available. Staff had access to a 24-hour emergency on call system should they need additional support when managers were not available at the service.

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. Reasonable adjustments were made based on individual needs, including bathroom adaptations to improve mobility and the use of mobility equipment. The provider worked with healthcare partners, making effective use of the GP visiting service and exploring home‑visit options for diabetic eye screening to reduce health inequalities.

People were supported to take part in the local community, and staff had completed equality, diversity and inclusion training.

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.

Key worker meetings contained some goals. However, these were limited, and we could not be assured people had been fully involved in setting them or they reflected the person’s own wishes and choices. End-of-life plans had not been explored with people. People had been supported to go on holidays and had plans for future trips. However, there was limited evidence to show how these decisions had been made or whether people had been fully involved in the planning process.

This lack of structured and meaningful future planning meant people were not always empowered to think about or express what was important to them. As a result, the service could not be confident it was supporting people in a way which aligned with their personal aspirations or preferences.

The registered manager told us they planned to introduce “wishes, wants and needs” books to help people identify what mattered most to them and to guide future planning. However, this had not yet been implemented and had not influenced practice at the time of inspection.