Gemcare South West Plymouth

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 service at its new office location. This key question has been rated requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care. People were not always treated as individuals and their care and support did not meet their needs and preferences.

This service scored 50 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Some care plans had basic information such as ‘assist me with having a strip wash’ and ‘like to try and shower once a week. Wash and dry’. The lack of detail meant people may not have received care and support in line with their preferences.

People did not always benefit from being supported by staff who had time to get to know them. In addition, care plans were not always up to date. This meant people’s preferences may not be met.

However, other people told us they had been involved in their care plans and staff knew their preferences. One staff member said, “People like things done in a certain way and just by chatting to them and getting to know them and listening you learn these things.” However, as reported in the safe key question section, due to poor rota management staff did not always have time to chat with people.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

People told us they did not always receive the care and support that had been paid for. Some care visits were early or late and care staff did not always stay for the duration of the visit.

However, most people told us they usually had regular staff. Some staff said they saw the same people regularly. Comments included, “I usually see the same set of clients and I know if they are well and I know their needs and I think continuity of care is the way forward” and “I see the same people so that is good.”

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

Care plans were not always up-to-date. There was not always enough information for new staff to know how to best communicate with people.

However, where staff knew people well, they told us they observed people’s body language or facial expressions to better understand and respond to them.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not involve people in decisions about their care or tell them what had changed as a result.

Some people told us when they made complaints or raised concerns, they were not listened to and action was not taken to resolve issues. Comments included, “The office do not seem to listen properly. When we call about the timings or if I text them they don’t respond” and “Some staff stay as long as they should and some don’t. I have told the office about it but it doesn’t seem to go anywhere. I have put comments on their app but it isn’t read as far as I can tell. They don’t always call me back.”

However, other people told us they had no complaints and felt able to speak with staff. One person said, “If I need to call the agency they’re helpful and friendly.”

The provider did not always make sure that people could access the care and support they needed when they needed it.

People told us and records confirmed visits were not always carried out in a timely manner when support was needed and there could be delays. People said, “They have been very late and they don’t let us know” and “Timings are all over the place.”

Several staff told us they had found it difficult to get through to the on-call service on the telephone, if they needed support while on a visit. One staff member commented, “It’s in Blackpool, not Plymouth. They don’t know the clients, they don’t know us. We have to go through the same questions over and over again and I get that it’s for security but it takes our time away. Communication is not good”. Staff told us there had recently been no staff in the office and the doors were locked.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People did not always have good outcomes and experiences. They did not always know who was going to attend their care visit, when it was going to take place, and staff did not always stay the full length of the visit.

Staff told us how they treated people equally and without discrimination.

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.

During our inspection, we found an end-of-life care plan had not been put in place and shared with staff to ensure a person was supported to have a comfortable and dignified death.

However, where people had advanced wishes about end-of-life care, these were included in their care plans.