Persona Domiciliary Support Service

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 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 most 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.

The provider was at the start of their process to transfer people’s paper files to electronic records. Some information had been omitted during the transfer process. However, the provider responded quickly to address this during the assessment. The work to transfer care plans to the electronic system may have impacted on the quality of some care plans and may have made them less person centred.

Most sections of care plans and risk assessments were well written, person centred and included the support people required and how this was to be delivered.

Families told us they were involved in the care planning and reviewing process. One family told us that they, the provider and other professionals, “work well together.”

Changes in people’s needs were documented, and systems in place to ensure information was shared. The new electronic system could flag items that required immediate reading by staff and would prevent staff from progressing further if not read.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice.

Staff worked closely with community health care providers and knew when to refer people for specialist care. They accessed support, advice and treatment for people from a range of appropriate health care professionals. Health professionals were involved in people's care and regular multi-disciplinary team (MDT) meetings took place

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Each person’s communication needs and preferences were clearly recorded in care plans. During assessment we found people had their communication aids in reach and were able to use these to communicate with inspectors and staff.

An Accessible Information policy was in place. The Accessible Information Standard puts an onus on services to identify, record, flag, share and meet the information and communication needs relating to people with a disability, impairment or sensory loss. We saw care plans and other documents were in an easy read format.

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 and their families were given opportunities to provide feedback or raise concerns about the service. Regular meetings were held with staff, people and families, and families told us questionnaires on the service were sent to them. People were asked for their views in different ways including meetings, reviews, day to day conversation and questionnaires. Families mostly told us they felt listened to with one stating, “They [provider] listen to my opinions; I fill in questionnaires”.

People had meaningful input into decisions made. People had discussed in their ‘Your Voice Committee’, that holidays were important to them but the cost and the suitability of accommodation for their needs was an issue. In response to this, and in co- production with people, a holiday lodge was designed, built and adapted. People and staff could rent this at a reduced rate.

One home had introduced regular meetings with people and the housing association to discuss any concerns or improvements to the property.

Robust systems were in place to investigate and respond to concerns. We followed two concerns to track the process from start to finish. We found good management of the concerns and saw how any changes were feedback to people, families and staff to ensure transparency and learning.

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

Staff attended relevant training and understood the needs of the people they supported. The provider understood the barriers that could prevent equal access to services for people with a learning disability and autistic people. People were supported with communication aids, hospital passports and making/requesting reasonable adjustments where necessary. All information was available in accessible formats.

One incident of a missed hospital appointment was noted; this was due to a staffing issue. The appointment was rescheduled quickly, with a familiar member of staff supporting the person to attend.

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 provider listened to the voices of the people they supported and ensured that care plans and records were person centred and reflected people’s beliefs, preferences and personalities. People were supported to access health services and reviews with health and social care professionals, but we found advice and plans were not always followed.

Staff completed regular training in equality and diversity to understand and reduce inequalities for people. Staff we spoke to all had a good understanding of how they put this training into practice.

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 did not routinely support people with end-of-life care, and no one was being supported with end-of-life care or in receipt of palliative care at the time of the assessment.

End of life training could be facilitated, and support could be provided working alongside community professionals, when needed. Care plans did not always contain details of people's end of life wishes as they mostly supported younger adults.