Time to Care Specialist Support Services Limited

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• 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 changed to requires improvement. This meant people’s needs were not always met.

The service was in breach of 1 legal regulation in relation to governance and oversight.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The staff made sure 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 their needs.

Relatives told us they were involved in their loved one’s care. One relative said, “We are involved in meetings and reviews, we have good communications. They listen to me if I have a grumble and sort it out, like when they send a new staff member as an introduction and (person) doesn’t like them."

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

There was limited documented evidence that people, and their relatives were involved in making decisions about their care.

There were mixed views from relatives on the provision and continuity of care. One relative said, “I don’t always feel informed and sometimes they don’t always tell me when they can’t come.” Another said, “They keep me up to date and informed and respond if I have any concerns.”

Some staff teams were consistent in the main, although we received feedback that staff were at times moved to other services which impacted on the continuity of care people received.

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

Care plans and care records had not been created in a way that enabled people to be involved in meaningful discussion and decision-making.

The nominated individual was aware of the Accessible Information Standard and said documents could be provided in different formats to meet people’s needs. An easy read complaints procedure was in place.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

A complaints log was in place and outcomes recorded however no learning had been documented. For example, there had been a concern raised about social media use but there was no learning in relation to increasing staff knowledge about boundaries.

Some relatives told us they were able to raise concerns and things were resolved. However, 1 relative said, “I have complained before, but it appears to go in one ear and out the other.”

Surveys had been completed by some people. However, there was no indication of when these had been completed, and no evidence of analysis or action taken. Some surveys shared with us related to feedback from people who were not in receipt of regulated activity.

Compliments were logged and positive feedback had been shared with the relevant staff.

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

Relatives were happy with the care and support staff provided. One relative spoke with us about how the staff were working alongside a health professional to support the person to attend health care appointments so they were less anxious.

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

People’s needs in relation to mobility, epilepsy and nutrition had not always been robustly assessed or action taken to explore and develop support strategies. This meant there may have been missed opportunities to enhance people’s experiences and provide better outcomes.

Staff understood that for some people a consistent staff team was paramount to their wellbeing and positive outcomes. One staff member shared that they had raised the need for consistency several times with management. They said, “We raise it all the time but staff are often moved, it’s like we aren’t listened to and our knowledge of people isn’t acknowledged."

The nominated individual said, “Staff don’t have contracts to work in specific settings so there are benefits to moving staff around. They don’t get complacent and can learn new skills.” The acting manager said, “We do have some staff who are trained specifically to support some people so we wouldn’t move them."

People were not 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.

There was no information in care plans to evidence that people were supported with planning for the future. The absence of this information limited the provider’s ability to ensure care remained person‑centred and aligned with people’s choices as their needs changed.