London Care - Brighton

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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.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has changed to Good. This meant people’s needs were met through good organisation and delivery.

Previously, the service was in breach of legal regulation in relation to governance about complaints at the service. Improvements were found at this assessment, and the provider was no longer in breach of this regulation.

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.

Previous areas requiring improvement identified at the last inspection had been met in respect to the detail of information recorded in people’s care plans and staff having accurate and up to date information to guide them. People and their relatives told us they had a care plan which reflected their needs, and they were involved in its development and review. One person told us, “I did a telephone survey 2 months ago.” Feedback from staff and leaders confirmed people were fully involved with their care planning and where appropriate, any relatives or significant others. People’s care plans reflected their physical, mental, emotional and social needs, including those related to protected characteristics under the Equality Act. Staff told us they had access to people's care plans and that they were regularly reviewed and updated. They told us care plans were informative and provided clear guidance on how to support people.

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.

Previous areas requiring improvement identified at the last inspection had been met in respect to the detail of information recorded in people’s care plans and staff working in a joined-up way with professionals. People and their relatives told us they were involved in decisions about their care and support. They told us staff supported them to access other services as and when needed. A relative told us, “[My relative] needed an ambulance. They stayed with him until it arrived.” A member of staff told us there was a joined-up approach to care from both internal and external services, and how they regularly engaged in reviews of people’s care. Staff told us they had developed good working relationships with other professionals that were involved in people’s care and support. Processes were in place to ensure when people’s care involved external services, it was delivered in a co-ordinated way which met their needs and preferences.

Feedback from external partners confirmed people received care and support from staff which met their individual needs. One external professional told us, “Staff generally present as confident in their practice and knowledgeable about the individuals they support.”

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

Previous areas requiring improvement identified at the last inspection had been met in respect to people having access to information and communication with staff. People told us they were provided with the information they needed about their care and support and had access to systems that allowed them to communicate more effectively. A relative told us, “They listen, [to my relative] he is virtually stone deaf, so they converse with him on a board like an Etch a Sketch.”

Staff and leaders confirmed people’s needs to have information in an accessible format was assessed and recorded. These needs were met and reviewed to support people’s care and treatment in line with the Accessible Information Standard. Staff confirmed they supported people to access and understand information relevant to them. Polices, such as safeguarding and complaints, could be provided to people in formats which were accessible for them. If required, people were able to use alternative forms of communication in their care plans and risk assessments to ensure their understanding, for example, by the use of pictorial information or large print.

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.

Previous areas requiring improvement identified at the last inspection had been met in respect to the complaints being managed in line with the provider’s policy, and mixed feedback from people in relation to being able to comment on their care. People said they would speak up if they had any concerns and were confident they would be listened to. A relative told us, “At the very beginning I made a complaint about the timings, as our time was between 8am and 9am, and they sometimes came at 10:30am. This has now been sorted when I flagged my concern.”

Feedback from staff and leaders confirmed they actively listened and involved people. They described how they communicated with people in a way they understood, and which was meaningful to them. A member of staff explained the formal complaints procedure to obtain people’s feedback. Staff knew about the complaint's procedure. Staff told us they would take complaints seriously and follow the provider’s complaints procedure. Processes were in place to ensure people’s voices were heard. There were opportunities for people to make a complaint or feedback to staff at any time. Any concerns raised were treated professionally and as an opportunity to learn.

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

Previous areas requiring improvement identified at the last inspection had been met in respect to people not being supported in line with their needs. Feedback from partners confirmed people had free choice and access to any external service provisions they required. Processes were in place to ensure people did not experience any barriers in accessing the care and support they required. The service supported people to access external care and support where needed, such as healthcare professionals.

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.

Previous areas requiring improvement identified at the last inspection had been met in respect to people not being supported in line with their needs. We could not get direct feedback from people in relation to equity in experiences and outcomes. However, feedback we received from staff and documentation we saw showed that people, sometimes with support, were in control of their care. Staff had completed training around Equality, Diversity and Human Rights (EDHR), which helped to recognise, promote and protect people's protected characteristics. Staff showed a good awareness of what discrimination meant and how to challenge any concerns. Processes were in place to help ensure people’s care, treatment and support promoted equality, removed barriers and protected their rights. Care plans contained information about how people’s social, cultural and spiritual needs should be met. Training records showed staff received equality and diversity training which helped them to understand discriminatory behaviours and practices.

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.

Previous areas requiring improvement identified at the last inspection had been met in respect to the detail of information recorded in people’s care plans and staff having accurate and up to date information and training to guide them around people’s future wishes. People were involved in decisions about their future, such as staying in their home for as long as possible, and they felt listened to. Staff told us they held conversations with people about their future plans. Staff had received end of life care training, including support from external health care professionals if this was needed. Staff were issued with end of life cards to guide them in the event of someone’s death. They contained information around any cultural requirements, how to care for a person after they had passed away and how to offer support to the family and loved ones. There were systems in place, to ensure people had access to the right care and treatment at the time they needed this. People's care records contained information about their long-term plans, which included, living more independently in their home.