Bosun Care Limited

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 of the provider’s previous registered location, 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 legal regulation in relation to person-centred care.

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 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.

Improvement was needed to demonstrate people were at the centre of their care and choices and how staff had responded to any relevant changes in their needs. We were not assured people always received support based on their preferences or in line with their needs and best interest decisions. For example, staff daily notes did not always show they had supported people to eat a healthy balanced diet or improve their mobility.

People’s care records were extensive and reflected their emotional and physical support needs; however, it was not clear how staff supported people to live a life of their choice and in a meaningful and personalised way. Information about people’s likes and backgrounds had been recorded, however it was unclear how staff had positively used this information to support people in a personalised manner and help prevent and de-escalate incidents which may have triggered their emotional well-being.

Staff provided examples of how they had supported people to overcome barriers and fears such as going shopping, however the strategies used to support people’s progress had not been recorded to ensure there was consistency across the staff team who supported people.

We were not assured from people’s care records they had been supported to access routine care and health checks and specialised care, treatment and support when required and the outcome of the appointments. There was limited evidence of how people had been empowered or supported to manage their own health and wellbeing needs and involved in regular reviews of their health and medicines.

People’s care records prompted staff to encourage people to make healthier choices such as healthy diets. We were told people had been supported access different resources within their local area for both health support and leisure, However, people’s records did not always reflect or support this goal or activity.

Whilst people had not consented to speaking to us, we were unable to determine from their records whether they lived in a home of their choice which had been decorated to their taste and preferences. People’s ability and the support they required to manage their tenancy agreements and raise any maintenance issues had not been assessed or recorded.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. The provider employed a large diverse staff team and tried to ensure people received support from regular staff to support their continuity of care. The registered manager said they worked collaboratively with key professionals and services when people moved into the service to ensure continuity of care.

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

People’s communication needs were assessed and known by staff. For example, some people required more time to process information or had used picture stories to help them understand information. Staff had patiently worked with people to understand and to develop their own unique communication ways; however, these preferred methods were not always documented to assist staff in maintaining consistent communication.

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.

Prior to our assessment, we had received mixed views from people, key professionals and other stake holders about the provider’s response in communicating with them and ensuring their concerns has been effectively resolved or responded to in a timely way.

We found systems were in place for people to share feedback and ideas, or raise complaints about their care, treatment and support. The deputy manager said they spoke to people regularly and managed any concerns immediately. The provider had conducted a survey to gather people’s feedback on the service provided; however, it was not clear what actions had been taken to address the concerns and comments which were highlighted in the survey.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Whilst people had been supported to access the service and understand the reason for attending appointments using social stories (pictures and short sentences used to support people to under situations and events), it was not clear if these tools had been consistently implemented and had been effective in enhancing people’s understanding of the services available to them.

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 registered manager was aware of inequalities and the prejudices people receiving support may face. They said they worked with people to help them feel empowered and understand their human rights but also the views of others. Policies on Equality and Diversity were available to staff.

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.

The registered manager explained how sensitive conversations with people about planning for their future were ongoing and carried out in a sensitive manner. However, records of the outcomes of these ongoing conversations or records of future planning in people’s best interests were not documented. Staff had not received training in end-of-life care and were not always aware if people had ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) in place. This meant people may receive end of life care in a manner which may not suit their needs or preferences.