Melton Care Services Limited

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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 ensured that people were at the centre of their care and treatment choices, and they decided, in partnership with individuals, how to respond to any relevant changes in their needs.

People received care and support from staff who knew them well. People and relatives confirmed that they were supported by regular care staff with whom they had formed a positive relationship, and who knew and understood their care and support needs. People confirmed their preference for male or female care staff was sought before care commenced. A person said, “Yes, (consulted about staff gender preference) and has been respected.”

People gave examples of how the service was flexible to their needs and requests. Whilst 2 people told us they wanted their care calls at different times, we were aware this had been formally requested, and the management team had advised changes would be made as soon as possible. Other people told us how they had requested changes to their care calls to enable them to attend appointments, which had been accommodated. A person said, “Yes, they (management team) will try to work around it if I have a hospital appointment, anything like that, so they come before or after. They are very helpful in that way.”

People’s care plans provided guidance for staff on the care and support required at each call, reflecting the person’s individual routines and preferences.

The provider’s systems and processes enabled people to be at the centre of their care. People were continually involved and consulted about their care and support.

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.

Staff collaborated with other professionals to ensure that people’s needs were met and made timely referrals as needed. For example, care records confirmed that the management team had made referrals to external healthcare professionals for further assessment and advice and also liaised with people’s social worker or the local authority adult social care team.

Staff understood how to appropriately support individuals with protected characteristics under the Equality Act. Staff were knowledgeable about people’s cultural and religious needs. A staff member said, “It’s important to understand and respect people’s history, religious and cultural needs.” Another staff member said, “We meet people’s cultural needs by respecting different dietary preferences that may relate to religion or culture and by allowing them space and time to honour their religion.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. However, some improvements were made as to how people’s communication needs were assessed and planned for.

The Accessible Information Standard (a legal requirement for social care providers to ensure information and communication is provided in a way that meets people’s needs and can be understood) required action to ensure it was fully met.

People’s care plans provided staff with guidance on their communication needs. However, this guidance was not consistently detailed. For example, although people’s sensory needs had been assessed and planned for, staff were not given any direction on how to support individuals whose first language was not English. As a result, further action was needed to ensure all reasonable steps were taken to remove communication barriers, enabling people to be fully involved in their care, make informed decisions, and understand important information about their support.

The provider’s service user guide provided information for people about what they could expect from the service, including relevant contact details. The registered manager told us that this document could be made available in alternative formats, such as other languages, large print, and easy read.

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 had access to the provider’s complaint policy. People and relatives confirmed they were aware of how to raise a complaint. People told us they felt able to raise a complaint if required and that it would be responded to in a positive manner. People told us where they had raised a concern, it had been acted upon, and improvements had been made. A relative said, “Yes, the management team are absolutely approachable and listen, no complaints whatsoever.”

Complaints received were minimal and showed that timely action had been taken to investigate and respond, including advising people of the actions taken, the outcomes, and offering an apology. This included information sharing with staff and reviewing internal procedures.

People received 3 monthly reviews of their care package. This enabled people to be fully involved in their care. We saw examples of review records that confirmed actions taken in response to people’s feedback.

The provider had quality assurance systems and processes. This included an annual satisfaction survey. Feedback was analysed for any required actions for improvements.

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

The service was responsive to people’s changing needs. For example, the management team were as flexible as possible in facilitating changes to people’s care packages.

The electronic care monitoring data and feedback from people and staff confirmed that the service was reliable. There had been no missed calls, and care calls were largely within the scheduled expected timeframe. People consistently expressed positive feedback about the service they received.

People’s care records confirmed they received care in line with their assessed needs. This included having regular care staff.

Out-of-office procedures were available to support staff and people who used the service. Staff were aware of their role and responsibilities in relation to escalating concerns to the management team to protect people from experiencing any barriers to their care and support.

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.

The management team supported individuals and their relatives in signposting and accessing services, including healthcare and assessments, to ensure they received the care and support they needed.

The management team made timely referrals to external health and social care professionals to support individuals in accessing the right care and support when needed, thereby achieving positive outcomes.

The management team and staff were alert to discrimination and inequality that could disadvantage different groups of people in accessing care, treatment and support.

The provider had an equality and diversity policy providing guidance on the importance of treating people equally. This was further supported by staff training.

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’s care plans did not always contain future plans, particularly information around end-of-life care. However, at the time of the inspection, no person was receiving end-of-life care.

staff had not received training in end-of-life care. We discussed this with the management team, who agreed to add this training to their staff training programme.

Some people had Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) and Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) and Advanced Decisions. This information was available for staff to ensure people’s wishes and plans were known and understood.