Jewel 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.

This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met.

This service scored 46 (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.

People did not always receive person centred care visits, at times that met their needs. For example, we saw evidence of a person’s commissioned call time being 10.45am, however office staff were rostering their care visits for staff to attend from 6.25am. The latest the person’s care visits were planned for was 9.25am. Staff arrived to deliver care from 7am on some days, which is much earlier than the person’s commissioned call time, and corroborated our view, and people’s and their relative’s views, that care was not delivered at consistent times in line with people’s wishes.

A relative told us, “One day [staff] would come at 6am to wake [family member] up, and the next day it is 9am. [The times] are just so erratic.”

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

People did not feel they received the care they paid for or which was allocated to them. Feedback from both people and relatives was poor regarding the length of time staff stayed at people’s care visits. One person said, “I had a dispute with the agency because the carers were not staying for as long as they were being paid. They are booked for half an hour but leave after 20 minutes.”

A relative explained, “I reported to the social worker that the carers do not stay for the required time agreed. They [staff] tell us they are under pressure to rush off to the next job.”

Another relative said, “[Staff] are supposed to be here for 30 minutes, but we usually have them for 20 minutes, which isn’t enough time to complete the tasks.”

We were told new staff did not always shadow experienced members of staff. One relative said, “There is a turnover of staff, and the new people don’t shadow the carers working. They just turn up and don’t know where things are.” This impacted the provider’s ability to deliver good quality, continuous care.

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

Feedback from people and their relatives was mixed in respect of knowing which staff would be attending planned visits. Several people told us they did not know who was coming from 1 call to the next, 1 person advised it was always a carer from a small group of staff and they knew them all well, and another person advised they had an app on their phone which provided them with the information they required about their next visit.

We were advised communication was an issue, especially due to a language barrier between some staff and the people using the service. One person said, “Communication is a bit a problem with [some] carers.” A relative said, “I embrace all cultures, but you need good communication when you are looking after someone with cognitively challenging needs.”

Whilst people’s care plans required improvement regarding the detail around their communication needs, staff did understand on a practical level how to support people to communicate. One staff member said, “If a client has hearing difficulties, ensure their hearing aids are worn, charged and not broken, and include this in the handover.”

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 always involve people in decisions about their care or tell them what had changed as a result.

People and relatives had differing feedback on how the provider listened to them. Relatives found communication with the provider to be difficult, with one relative saying, “If I want the time changed, for example when I wanted it changed from 7.30am to 9am, I had to tell them several times and also email them before it actually happened.” Another relative explained, “[Jewel Homecare] need to listen to the needs of the person. That’s the real shame of it.”

People felt the manager was good and would listen to them if they needed to raise a concern. One person said, “I know the managers and can contact them.”

We saw evidence that some people were contacted to provide feedback on their care, however this wasn’t present in all people’s care records.

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

Relatives advised us of some difficulty when trying to contact and liaise with the office.

People, and relatives, did not feel they were always involved in the planning of their care, and some people told us they did not have a care plan in place.

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.

Initial assessments and care plans did not comprehensively reflect people's needs relating to their protected characteristics under the Equality Act 2010. Although some care records captured race, ethnicity, and preferred language, they failed to consider other key characteristics, including people’s sexual orientation,and their religion.

The provider did not demonstrate an approach that considered people’s experiences.This meant opportunities to improve people’s experiences and outcomes were missed.

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 did not always have clear, easily accessible information about their end of life wishes. One person had deteriorated and was now in receipt of end-of-life care provision. The end-of-life information we could find was very poor and did not record detailed wishes and how to deliver their care during the final stage of life. We immediately raised this with the provider, who shared a much more detailed end of life care plan, and advised this was under a section of the digital care planning system that was not easy to locate. They recognised this was not helpful for staff and agreed to move the information to a more prominent location to enable staff to find the information quickly and easily.

Most care plans we reviewed specified whether people had a Do Not Attempt Cardio Pulmonary Resuscitation (DNACPR) in place or not.