Better Care & Support Ltd

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 changed to 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 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.

Care plans contained information on what was important to people, their preferences, likes and dislikes. This meant that care staff could support people in line with what they had expressed. However, as detailed within this report, people’s preferences on care call times and gender of staff were not always honoured and respected.

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 using the service provided mixed reviews regarding continuity of care. Whilst some people had regular care staff, others told us this was inconsistent and staff did not know them well. With the changes in care staff, people’s choice was not always honoured. For example, one relative told us, “Once two male carers came instead of a male and a female. It’s not right. I refused the two males. I phoned the office, and they apologised and it hasn’t happened since.”

People also told us that communication could be a barrier to care. One family member told us, “It’s mostly male carers. [Person] would prefer female carers. Carers can be ineffective. Respectful, but don’t have the language skills to work with dementia. Their language skills are poor. Some do speak English.”

People told us that the staff are responsive, with one person telling us, “We phone the office when [person] goes to hospital to cancel care and they respond. I’ve spoken to [staff] at the office. To be fair their response is very good, nice and respecting. They give regards to [person]. It’s always easy to get through to them.”

Systems and processes were in place to promote joined up care, including leaders working with other professionals, making appropriate health referrals and following up any actions required following appointments. One person told us, “Recently [staff] phoned the G.P as [person] had a bedsore and the district nurse came. The nurse gave some cream to put on. A referral to the chiropodist was made.... The carers also called the G.P for a urine infection.”

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

People’s communication needs were assessed during the initial assessment process, with information recorded about how staff should communicate with them. This included information on any equipment used to improve communication, glasses and hearing aids for example.

The provider ensured information was available in formats which suited each person’s individual requirements.

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 and their family, friends and other carers understood how to give feedback, share ideas or complain about care, support and treatment. Some people had received satisfaction surveys or been asked for feedback, while others had informal conversations with staff about their care. We saw evidence where people had given feedback and the provider had used this to make changes to the care that people received. However, feedback from people and their families was that the changes were not long standing. This meant that people were not always fully listened to.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.

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.

We saw that people were supported to plan for important life events, including their wishes for end-of-life care and funeral arrangements.

Systems were in place to inform staff of people’s choices regarding their end of life care decisions. We saw evidence of ReSPECT forms being stored electronically. A ReSPECT form (Recommended Summary Plan for Emergency Care and Treatment) is used to record a person's wishes and preferences for their care, so that in an emergency, treatment can be provided in line with what matters most to them. This ensured that individuals medical and care needs were shared, enabling professionals to respect them.

Care plans included detailed information that reflected what mattered most to each person and who they would like to be consulted and involved when they approach their end of life.