Archangel Home Care

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.

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

This service scored 64 (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.

Care plans genuinely reflected people’s needs, preferences and long-term aspirations. Staff worked with people when their needs changed to consider the care and treatment options which best met their changing needs and this was then reflected in people’s care plans. Staff said about the care plans, “They have information on personality and are thorough on how people want to be supported in each area such as with finances, their home, relationships…Staff are encouraged to update these if a (person) provides new, or changes information.”

Staff had all completed training in person-centred working, and they ensured people were appropriately involved in planning their care. A relative spoke about the way staff included both them and the person who was to receive the care when completing the initial assessment, the relative said, “The whole time (the staff member) was addressing my relative at the same time as involving me.”

People told us care delivery matched their care needs however, records of care did not always reflect that. Staff did not always keep clear, comprehensive care records especially around personal care tasks completed. For example, people supported with creams told us the staff supported them with this, which was stated in the care plan, however staff daily records had not recorded this was done.

Staff provided appropriate support to maximise people’s involvement in decision making and care planning, so it genuinely reflected their needs and preferences. This included making reasonable adjustments and enabling involvement.

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 identified and took appropriate action when there was a gap in a person’s care. This included where people were eligible to receive more care or support. Staff said, “Staff can raise concerns or things they have noticed regarding (people) and their needs. Staff are sometimes present when social workers are visiting (people) and can help give a better picture of the situation for the social worker.”

People received the funded care and support and the service worked with commissioners to ensure that continuity of care was managed. Commissioners who worked with people supported by Archangel Home Care said they had no concerns with the care the service provided. One professional said, “They have worked to improve the life of the (person) that they have been commissioned to support.”

The service understood the diverse health and social care needs of the people that used their service and the relevant local communities and tailored support to meet those needs. The manager and staff shared how local community organisations were accessed to support people when they were in need and when they wanted to access community activities, and people confirmed this.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Information and advice were not always available in a way that people being supported could understand. Some policies stated they could be made available in different formats or languages if required, but this was not always the case. The policy for accessible information and communication did not contain enough details about how information would be provided to people with alternative needs, for example if a person wanted to raise a complaint about the provider. However, the provider improved this after the inspection had commenced.

People’s individual communication needs were identified and recorded in care plans. Risk assessments provided details about how staff could best support people with communication needs. One staff member said, “When the (person) is trying to communicate with me about a topic, I take the time to try and understand what (the person) is trying to get across and I try to use my basic Makaton skills to communicate back to (them).”

All staff had received training in communication. Staff said, “To ensure I know a (person’s) choice and wishes, I firstly try to connect with them and understand which communication method is needed best so that they can communicate with me on what they wish to do/ have.”

Staff understood data protection requirements and ensured information was shared appropriately and only when required. One staff member said they understood the importance of only sharing necessary information, they said, “Information is shared on a need-to-know basis with staff, (people) and family as outlined in confidentiality policy.”

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

People were asked for feedback formally. However, records showed anonymous feedback from people using the home care service was collected together with feedback from people receiving a different type of service from the same provider. This meant the provider could not identify where concerns or compliments had come from to inform improvements.

Where feedback was obtained individually, people felt confident their views or concerns were taken seriously and the appropriate action was taken if they raised a concern or complaint. One person said, “They regularly ring me up to ask me how my support is going, if I am happy with things, and if the carers are on time.”

Where people’s friends and families were involved in people’s care, for example when people were unable to communicate effectively, there had been no recent formal request for feedback. However, people’s friends and family said when they approach the provider themselves and have given feedback, this was taken seriously. One relative said, “I contacted the office and found them to be very responsive. The concern went to two or three different managers, and they investigated it very thoroughly.”

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

People were able to access care, treatment and support in a way that worked for them, regardless of any protected characteristics. For example, where people had a disability, staff ensured communication supported that individual to access care in a way which supported them best. One staff member said, “Different techniques are used to support service users in person centred ways, e.g. pictures cards of staff are provided to help service users with names and faces.”

People received care, treatment and support in a timely way and in line with best practice, quality standards and legal requirements. Staff told us people had been supported to have care at a time that worked for them, around their cultural needs. The manager provided examples of this. People told us their care met their needs. Whilst a relative said, “The carers are patient, they never rush my relative which is important, even if ours is the last call of the day, they always take their time.”

Reasonable adjustments are made to ensure equal access to both Archangel Home Care and other health services. This removed barriers for people who may find it hard to access services. For example, people who required additional help to access health appointments were provided with support to achieve this.

Leaders and staff were alert to discrimination and inequality that could disadvantage different groups of people in accessing their service whether this is from wider society, within organisational processes and culture or from individuals. Managers and staff have all completed equality and diversity training, and a robust policy was in place. Staff talked about wanting to learn more about the different cultures of the people they supported.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care and support in response to this.

People had good outcomes and experiences of the service regardless of their needs, backgrounds or protected characteristics under the Equality Act. All people, and where relevant people’s families, said they were happy with the care provided by Archangel Home Care.

Staff were well trained to support people’s individual needs. The knowledge staff and leaders had of the people they supported assisted them to provide care tailored to people’s needs. A staff member said, “The management team often teach me new things, ways of providing support and doing my job effectively. They are good leaders who know their staff and service users very well.”

People felt confident staff were genuinely interested in their views and took these into account when developing the service. One relative said, “(The staff member) spoke about their values and wanted to know about my relative’s family life, history, and hobbies, which I thought was all really good.” Care plans reflected people’s individual needs and life stories, which ensured every person’s experience was suitable to their own needs.

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 preferences about the future, including decisions related to the care they would like at the end of their life had not always been identified and documented. Care plans reviewed lacked detail about the person’s wishes and there were no records which showed conversations had taken place about this with the person, or their friend or relative.

Care plans were not always reviewed annually. This meant opportunities to record changes in people’s needs and wishes regarding their future care may have been missed.

Where people did not want to discuss their end of life wishes, steps were not taken to establish what to do in an emergency medical situation. There was no plan to revisit the subject in the future in a different way.