Homelium West Sussex

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 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. They did not always work in partnership with people to decide how to respond to relevant changes in their needs. Care plans included information about people’s routines, preferences and what mattered to them. Some people and relatives said their needs had been discussed when care started, and the service responded flexibly when changes were required. However, review records did not consistently demonstrate how people were supported to take part or how their own views informed decisions about their care. In several reviews, feedback was primarily provided by relatives and records did not clearly show how the person’s own views had been obtained. For example, one person’s review recorded information provided by their relative, but did not show how the person had been supported to participate. This meant the provider could not be assured that people were consistently involved in reviewing and making decisions about their care.

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. People and relatives said the service worked flexibly to adjust visits around healthcare appointments and changes in their circumstances. Staff worked with relatives and health and social care professionals when people’s needs or equipment changed. Professionals spoke positively about the provider’s communication and joined-up working. Some people and relatives said they did not always know which care worker would attend and did not consistently receive support from familiar staff. One person said, “It is hit and miss if we see the same people, sometimes I will call the office to find out who is coming.” The provider acknowledged that staff absences and the availability of some care workers had affected consistency. This meant people did not always experience continuity of care from staff who knew them and their needs.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The provider had a service user guide containing information about the service, how to contact staff and how to raise concerns. Care plans recorded people's communication needs, sensory impairments and whether information needed to be provided in an alternative format. People and relatives said they had the relevant office contact details and could contact the service when they needed information or wanted to change a visit. Staff could access care records electronically and people could request access to information held about their care. This helped people and those important to them understand how the service operated and how to contact staff when needed.

The provider made it easy for people to share feedback and ideas or raise complaints about their care and support. Staff responded to concerns and informed people about the action taken. People and relatives knew how to contact the service and described managers as friendly, approachable and responsive. Some had raised concerns about late visits or the care workers supporting them and said these had been addressed. One relative said, “I have had words occasionally, nothing major, handled well and I was satisfied with the action.” Although formal surveys had not always been completed to a regular schedule, people and relatives had direct access to managers and felt confident raising concerns. This meant people were able to speak openly about their experiences and have their concerns addressed.

The provider did not always make sure people could access the care and support they needed when they needed it. Some people experienced late visits and care was not always delivered at the planned time. One person told us an agreed visit had been missed. A relative also said their family member had experienced a missed visit and told us, “[person] had a missed visit, but I was informed and we had to manage.” Call-monitoring records and staff feedback showed rotas did not always allow enough travel time between visits, which contributed to delays building throughout the day. This meant people could not always rely on receiving their planned care at the expected time, which reduced the reliability of the service. However, people and relatives knew how to contact the office if they needed to cancel or rearrange a visit, and staff could access management support outside office hours.

Staff and leaders did not always actively listen to information about people who were most likely to experience inequality in their experience or outcomes. This meant people’s care was not always tailored in response. One person communicated non-verbally and had significant communication and sensory needs. However, the provider had not completed a person-specific care plan or risk assessment setting out how staff should communicate with them, recognise distress or support them to express choices. This meant staff relied on their own knowledge rather than clear guidance, increasing the risk the person’s wishes and needs would not be consistently understood or acted on. Staff had completed equality and diversity, communication, learning disability, autism training and described adapting how they communicated. However, this approach was not reflected in the person’s care records.

People were supported to plan for important life changes, so they had enough time to make informed decisions about their future, including at the end of their life. Sampled care plans recorded whether people had a do not attempt cardiopulmonary resuscitation (DNACPR) decision or a Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) plan. Where these were in place, some care plans recorded where the documents were kept. One person’s care plan also recorded support from a hospice and community nursing teams. A relative told us they had been involved in discussions about the person’s current and future needs and felt these were clearly understood by staff. Staff had completed palliative and end of life care training. Staff understood the importance of supporting people through changes in their health and care needs. This showed people’s anticipated needs and important decisions were considered when planning their care.