Thames Homecare Services Greenwich Branch

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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 64 (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 make sure care records were always person centred. Although most people spoke positively about the person-centred care they received, we found care plans lacked sufficient detail to ensure staff would understand people’s needs and preferences. There was no information about people’s personal interests or hobbies. We found detail about people’s personal care and daily routines was minimal. This lack of detail meant there was a risk people would not get care and support in line with their personal preferences.

Notwithstanding these concerns, many people told us they were happy with the care they received, and they felt staff understood their personal preferences and routines. One person told us, “Staff know what support I need and how I like it to be performed.”

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.

People and their representatives consistently reported continuity of care as a major strength. Relatives valued having regular staff who knew their family member well, and good communication with senior staff and external partners. Comments included, “Initially I was getting lots of different carers, but it is much better now and I have the same two carers come all the time, I don’t have to keep repeating myself and telling them how I like things done” and “I get the same carers and they are wonderful, I could not say enough good stuff about them.”

The provider understood their responsibility to provide accessible information which supports people’s rights and choices. They told us they could provide information in formats tailored to people’s needs, including different languages, audio and large print.

People’s communication needs were recorded in their care records. Staff understood these needs and used the information to inform how best to communicate with and support people. Most people told us staff communicated with them well.

Systems were in place to ensure information about people held by the service was secure and sensitive data remained confidential and protected from unauthorised access and misuse. People also could access their care records via an online app. A person told us, “I find the telephone app helpful, there is a lot of information.”

The provider had processes in place for people to share feedback and ideas, or raise complaints about their care, treatment and support, however, these were not always being consistently applied.

The provider had arrangements in place to investigate complaints, supported by a complaints procedure that set out how concerns would be handled and what people could do if they were dissatisfied with the response. Most people who had complained were satisfied their issues had been taken seriously and resolved. However, a minority of people were not happy with how their complaint had been handled. A person told us, “I still haven’t received a response from them, and I spend my time constantly chasing them for answers.” The mixed response showed more work was required to ensure issues raised would be resolved appropriately. Notwithstanding these concerns most of the feedback about how the provider responded to complaints was more positive. A person told us, “I made a complaint in the past about a couple of the carers, but the manager addressed it.”

The registered manager understood their responsibility and was aware of discrimination and inequalities which could have an impact on people accessing care and support. The service worked in partnership with key organisations including the local authorities and other healthcare professionals to ensure people had access and received care in a timely manner.

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 understood people’s right to receive care and support that met these needs. They had received equality and diversity training to help ensure people received fair and equal treatment. Despite this we found people’s care records did not always contain sufficient information about their individual needs, including those relating to social, cultural and religious needs.

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. Discussions around future wishes did not form part of the assessment or care planning process. As referred to elsewhere in this report people had not been consulted about DNACPR decisions made about them.

The provider was not providing end of life care at the time of this assessment, however staff received palliative care training to ensure they had a good understanding of people’s end of life care needs.