IECC 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 requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to acting on and responding to complaints. The providers systems for identifying, receiving, recording and responding to complaints were not used effectively to identify failings and improve the service.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Improvements were needed to ensure people were always at the centre of their care and treatment. People’s needs had been assessed prior to using the service, including consideration of their physical, mental health, sensory, social and communication needs, and these assessments informed the initial care plans. Care plans were reviewed regularly; however, we identified occasions where records were inaccurate or inconsistent. These included incorrect personal information, the wrong name, or another person’s risk assessments included in records. For example, 1 person’s mobility risk assessment stated they were unable to mobilise independently and required support from 2 staff for transfers. However, the person was observed mobilising independently using their walking frame. Care plans had set out people’s needs, preferences and long-term aspirations, such as regaining confidence to mobilise independently with a frame, and to manage their own personal care. However, they did not always stipulate how staff were to support people to achieve these long-term aspirations and goals. Staff did not consistently use best practice, person centred language when documenting people’s care. Daily records sometimes contained terminology that lacked dignity and respect, particularly when describing people’s health and wellbeing. For example, staff had written, ‘He had a poo’.

People’s care was not consistently joined up, flexible, or sufficiently supportive of choice or continuity. As evidenced throughout this report, care was not always effectively coordinated or routinely tailored to people’s individual needs. People did not consistently receive the full level of care, support, and treatment commissioned or funded by the local authority for their homecare visits. The provider’s systems and management checks were not always effective in ensuring care was delivered in line with commissioned funding arrangements or privately paid for services. Where gaps in care provision were identified, the provider did not consistently take appropriate action to escalate concerns to the local authority or address failures to deliver the agreed package of care, support, or treatment in line with contractual arrangements.

The provider supplied appropriate, accurate and up-to-date information about the service in formats that were tailored to people’s individual needs. The provider had reviewed their statement of purpose [a legally required document for health and social care providers in England, outlining what they do, where they do it, and who they do it for] to reflect a separation between their homecare and supported living services. The revised statement of purpose now provides information and advice that is accurate and up to date, specific to the homecare service, including emergency numbers. The document was available in alternative formats, if requested, and included how to make complaint, including the details of other bodies to make complaints to such us Ombudsman, Local Authority (LA), Clinical Commissioning groups (CCG) and CQC.

The provider did not always make it easy for people to share feedback and ideas or raise complaints about their care. We received mixed feedback from people and their relatives’ about how their views or concerns were listened and responded too. Some said they had regular care reviews, and that they were listened to and understood, however others referred to lack of regular communication and updates about their relative. People and their relatives described difficulties contacting the office, a lack of follow-through on issues raised, weak complaint handling processes, and a reluctance to complain due to fear of negative consequences. Review of the complaints folder found there had been 11 complaints made about IECC Care in the last 12 months. Poor records made it difficult to separate if the complaint related to the homecare or supported living part of the service. However, we found 7 of 11 complaints raised issues about not informing people of changes in visit times, late call times and people feeling rushed. Although the complaints had been reviewed records were poor, lacking detail and poorly demonstrated outcomes and actions taken to ensure lessons were learned and used to improve the service.

Relatives told us that their family members did not always have access to the care and support they needed when required. The provider had not consistently ensured that people using the service had equitable access to care without experiencing unfair delays. Where people and their relatives raised concerns about the unreliability of homecare visits, the provider did not always use this feedback or other available evidence, including its own data, to improve access for those more likely to experience barriers or delays. This included people with protected characteristics, such as older people and those with physical disabilities.

The provider had not consistently identified or reduced barriers to inclusion or ensured equitable experiences for people using the service. While the provider was recognised for employing a diverse workforce, insufficient consideration was given to the impact of language barriers where English was not staff members’ first language. Relatives reported that communication difficulties had, at times, negatively affected people’s experiences of care, particularly for people living with dementia. One relative stated, “Staff language and people not understanding has on occasion led to misunderstanding of people’s needs, adding to stress and frustration.” Staff demonstrated variable understanding of discrimination, inequality, and the specific equality-related needs people may experience when accessing care and support. Some staff lacked confidence in recognising and responding appropriately to these needs. The provider had not consistently ensured staff received appropriate training to support inclusive practice, challenge discrimination, or work collaboratively with people and families to identify and address potential equity in experiences and outcomes.

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. Care plans did not always evidence how people were actively involved in planning for or discussing their future care needs, including end of life. Improvements were needed, including holding difficult conversations with people or their representatives to discuss their views, preferences, and wishes for care, ensuring these are respected if they later cannot make decisions or if unexpected situations arise.