Grace Care 24/7 Ltd

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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 68 (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 and relatives told us staff knew and understood people, and they were flexible in responding to their personal care needs. One person told us, “They always change my visit days if needed, no questions asked, so accommodating.” A relative told us, “They know and understand their needs and work with us.”

Staff felt they had the time to give the care and support they needed and knew people well as they worked with the same people on a regular basis. One said, “We always go to the same people.”However, care records did not always support person centred care. They lacked information on people’s needs and did not record people’s health needs. The registered manager and the directors recognised the need to improve care plans and information recorded to support care. The risks associated with this lack of information was however, reduced as staff knew people well.
 

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 their relatives told us they had regular staff, and they got to know each other.This promoted continuity of care from staff who were familiar with their individual care needs, preferences and daily routines. There was regular contact between the care staff and the managers which supported and promoted the continuity of the support provided.A staff member said, “We can communicate with people, it is not our choice how things are done, they have their own views and can say.”

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

People said they received information in a way that they understood. They said they knew who was coming to provide the care and support and all invoices and costings were clear. One said, “I have female staff always know who is coming and they let you know if they are changing them, they ring if they are going to be late.”

Information on the service was shared with people when a package of care was initiated along with a service agreement. This included information on how to raise a complaint or concern.

Due to the size of the service people knew who was visiting them through verbal confirmation. There was no formal system to notifying people of the planned schedule and this was raised with the registered manager and directors who agreed this would be addressed as there was an increase in the provision provided.

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.

People and their relatives said they were able and comfortable to speak to the registered manager or the directors to raise any issue or concern. They were confident that they would be listened to and any necessary actions would be taken. One relative told us,” I would call the office if I had any concerns.” Another said, “If I had concerns, I would ring the office, speak to the manager.”

The registered manager and directors confirmed that no complaints about the service had been raised and so there was no record of any complaint. The service had a generic complaints procedure which included a procedure to record complaints received. This procedure needs to be further reviewed to ensure clear and appropriate for specific use for this service. The directors agreed to update this procedure.

Staff were positive about encouraging people to share their views and any concerns. One staff member said, “No one has made a complaint to me, but I would pass anything on to the manager.”

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

When people requested a service an assessment of need was completed as soon as possible to facilitate quick access to a service if appropriate. People told us they could change how many and what kind of visits they had as their needs changed. One relative told us, “We sometimes need 2 staff members if X needs additional personal care, this is agreed with the manager and changes depending on what is needed.”

The manager or directors supported people to access specialist health and social care support when required and staff were aware they needed to call emergency services if required.

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 responded to people’s differences and looked to ensure people had good outcomes. One staff member told us about covering a person’s bandaged leg in plastic to enable a shower. Staff talked about respecting and valuing people’s differences including culture and religion. The registered manager talked about supporting people whose first language was not English when talking to health care professionals.

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.

People using the service did not require any support with end-of-life care at the time of this assessment. Staff had previously worked with people who were receiving an end-of-life package of care in the past. The registered manager confirmed they had worked with the local hospice staff during these times. However, the assessment process used did not take account of people’s wishes at the end of their life’s. Some people may have had records including Do Not Attempt Resuscitation (DNAR) or Recommended Summary Plan for Emergency Care and Treatment forms (ReSPECT), these confirmed people’s wishes and choices if they became unwell. The presence or otherwise of these was not recorded. It is vital that staff knew if these were in place and ensured they were shared with appropriate health professionals if needed in an emergency.