Alina Homecare - Dorchester

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 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 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.

People received personalised care that was responsive to their needs, wishes and preferences. Care plans were in an electronic format, staff had access to them on their smartphones. This meant any changes in people’s needs were shared immediately and staff were kept up to date with new information about people they cared for. Care plans contained person-centred details, including life histories, hobbies and interests, skills, abilities and how they preferred to manage their health. Staff had worked closely with people, their relatives and others important to them to ensure all their wishes and feelings were recorded. Staff had spent time with people and their relatives to gain real insight, and demonstrated they knew people, their routines, wishes and preferences very well.

Care plans were reviewed initially after 2 weeks, 3 months, 6 months and then every 12 months or more regularly if people’s needs had changed. This was done with the involvement of people who used the service and their representatives. Staff completed daily notes detailing the care they had provided which helped the management team to be aware of any changes in the person’s needs and to ensure there was continuity of care.

Staff enabled people to participate in person-centred activities and encouraged them to maintain their hobbies and interests. Care plans outlined people’s enjoyment of activities and went into detail about how staff might get the best responses from individuals. For example, we reviewed care plan of a person who was an art teacher for many years and still enjoyed going to an art club. Their care plan instructed staff to encourage colouring activities or attending art classes in the area.

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 told us the service worked well with other professionals when needed. This included local GP surgeries, district nurses, occupational therapists, social workers and pharmacies. Leaders were knowledgeable about people’s diverse health and social care needs. Staff made sure the multi-disciplinary team were involved when required. They gave examples of this and explained how other professionals were involved to ensure people’s wellbeing. We reviewed records of people who had regular input from other services; for example, there was input from the community mental health team, local GP surgery and frailty team. Staff worked hard to co-ordinate people’s appointments, making sure other professionals were aware of the person’s treatment and ongoing needs. Staff followed any guidance given, and provided information and feedback to professionals when needed, such as the effect of medication changes.

Staff had access to support in emergencies. An on-call system was in place to ensure support was available outside of office hours for both staff and people using the service.

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

The provider ensured people’s care plans and records captured how people were supported to engage in meaningful communication and decision-making. This enabled people to be active participants in their care if this was their wish. Peoples’ care plans clearly identified communication needs and what staff should do to support communication. This included ensuring people had access to any aids they required, such as prescription glasses and hearing aids. Staff adapted information to meet people’s individual communication needs. People and relatives told us staff communicated clearly during care, explaining each step and offering reassurance when needed. One person told us, “They are always going the extra mile when we need extra support and are always reassuring. If am poorly I get welfare calls from [manager’s name] to see how I am doing which is extremely kind.”

Care plans and daily care notes were available electronically, and relatives who opted in could monitor visit records and medicines via the electronic recording system, with people’s consent.

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.

The provider had a policy and procedure in place that set out the steps someone would need to take to make a complaint, and information on how to complain was contained within the service user guide. This ensured all complaints would be investigated and a response provided to the person.

People and their relatives confirmed they felt confident in the service taking appropriate actions should they raise a concern or complaint, which included looking into the issue thoroughly, communicating what was happening, being open about what had been found out and what the outcome was. The provider worked with people to agree solutions to concerns raised, and to measure the impact of the changes made. People, their relatives and others important to them confirmed they had meaningful involvement in service development and improvement through regular and open communication. The provider also used surveys and quality calls to seek and share information with people and relatives. One relative commented, “They have frequently asked whether things are going well, they listen to me and make changes.” Feedback forms were distributed regularly, and regular care reviews were completed with people to give them an opportunity to discuss their support.

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

People were able to access appropriate and timely care when required, including during weekends and bank holidays. When emergencies arose, the provider was responsive and flexible to ensure people still received the care they needed. For example, rotas were reviewed in adverse weather conditions or where relatives weren’t available to support people to ensure all people received the support they needed. One person told us, “There are always enough staff to ensure that my needs are met. If there is ever any emergency I am contacted straight away.”

The provider monitored visit attendance through the electronic log-in and log-out system. Alerts were sent to the office team if a visit had not been attended or if staff were running late. When this occurred, the team contacted both the staff member and the person using the service to check on the situation. Where necessary, a supervisor was deployed to provide cover and ensure the person remained safe. The provider had an on-call service to ensure senior staff members could be contacted at all hours of the day and night if needed for advice or for additional support on care calls.

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.

People’s individual needs were clearly identified during assessment and reflected in people’s care plans. For example, where people practised a religion or if they had specific accessibility needs, it was identified in their care plans. When people’s needs changed, care was adapted to ensure it was still tailored to them as individuals and they still received equal opportunities.

People were supported by staff who received equality and diversity training. Staff consistently supported people in a respectful and person-centred way to ensure equity of experience for them. In our review of records, feedback from people, relatives, staff and the management team we found people using the service were not being discriminated against and were experiencing the outcomes they required. People from different backgrounds were treated equally, and staff demonstrated sensitivity to individual needs, such as catheter care, textured modified diets or routines shaped by neurological conditions.

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.

The provider routinely facilitated discussions with people or their relatives regarding end of life wishes and preferences during an initial care assessment. Staff were aware of people’s wishes for the future, for example whether they wanted to go to hospital for further treatment or whether they wished to remain at home. People’s care plans informed staff whether they had a do not attempt cardiopulmonary resuscitation decision (DNACPR). DNACPR documents were stored in people’s homes. People’s lasting powers of attorney were documented in care plans, should people become unable to make decisions themselves. These decisions were recorded in respect documents, advanced care documents, and in people’s care plans.

Staff received training in palliative care to develop their understanding of caring for people at the end of their lives.