Right at Home Bexley & Dartford

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• 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 good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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.

Care plans were detailed in relation to most areas of people’s care and support needs. Some care plans lacked detail, these were amended by the management team during the assessment.

Staff described how they supported people at their own pace. People told us their care and support was person centred, they had consistent staff that knew them well. A person told us, “They are very responsive to my every care need.” Relatives told us the care and support met their loved ones needs. A relative said, “They are compassionate. They enjoy their job. They care for [loved one], they are nice people. At various points I have chatted to them. They are good at communicating.”

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 service worked with other health professionals involved in people’s care. Information was shared with staff regarding any changes to people’s health or care needs. When people were supported to go to hospital, either through routine or planned admission, emergency admission or consultation day visits, support was in place as well as hospital passports. A hospital passport helps people to give hospital staff important information about them and their health when they go to hospital.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The provider had an accessible information policy in place. The service supported people with a variety of communication needs. No one had written information provided to them in different forms at the time of the assessment. The management team told us they were able to change care plan fonts, source different coloured paper and could translate care plans to other languages as and when required. People could either have a paper copy of their care plans, or a digital copy was accessible. Relatives were able to review care plans and information as well. The registered manager told us information could be made available in a variety of ways to meet people’s needs. They explained a person found it difficult to communicate verbally on the telephone so communication with them was via text message or email.

Staff were aware of people’s individual communication needs for example, people who may have hearing or vision impairments.

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 carried out regular telephone monitoring calls and regular visits to people using the service. Surveys were undertaken to check people and their relatives were happy with their care. A person said, “The bosses come over, they want us to fill in a survey straight away, I don’t like to do that when they are there.” Relatives told us, “They ask how things are going”; “They send a survey, also they ask me when the manager comes to visit to check up on carers. She will ask if [loved one’s] needs have changed” and “3 or 4 days ago I had a questionnaire.”

Most relatives told us that the service was responsive to their loved one’s needs. Staff described how they listened to and respected people.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The provider shared how the service had enabled people to access the community. For example, a person had not been able to leave their home for more than 5 years. The service worked with them to enable them to attend an event at the offices which included a meal and drinks with other people who used the service and staff. Since this event the person felt enabled and empowered to make regular trips into the community with care staff. People and their relatives told us they were always able to make contact with the service when they needed to. A person said, “I can speak to the manager.” The management team told us that sometimes staff supported people with additional tasks to meet their needs.

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.

People had opportunities to feedback to the management team about their service. The nominated individual for the provider visited people regularly which enabled people to discuss their needs and expectations. A relative told us, “They keep us informed of changes and are responsive to Mum’s care needs.” A person said, “Communication with the company is very good. The office provides a very good service. They are very responsive, and I have no complaints. I would recommend them.”

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. Some people had a DNACPR (Do not attempt cardiopulmonary resuscitation) form in place. This is an advanced decision not to attempt CPR. It is not about other treatments or care. Staff told us they had received additional training to support them to provide end of life care when needed. A staff member said, “I did end of life training at the office and at Ellenor hospice. I make sure people are happy and comfortable.” A healthcare professional said, “The 12 staff that I have trained face to face with a 2-day course end of life champions. This course is very interactive; they demonstrated clearly that they are competent at reporting all changes in health/care needs” and “They were good at questioning, listening, then evidencing, empathy, dignity, and understanding of how important it is to ‘Get it Right’ in my opinion they are a very good team.” At the time of the assessment, no one was at the end of their life.