Peartreelifecare 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 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.
 

This service scored 54 (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.
Most care plans included information about people’s backgrounds, preferences and dislikes, such as favourite meals and routines. Staff we spoke with knew people well and responded appropriately when people’s needs or mood changed.
People were supported to make day-to-day choices, including when they wanted personal care, and technology was used to promote independence. Relatives gave examples of staff recognising changes in people’s emotional wellbeing and responding quickly, including advising families to seek medical support when needed.
However, we could not be assured person-centred planning was consistently meaningful. People and relatives were not always fully involved in reviewing care plans, and some records did not reflect people’s longer-term aspirations. This was discussed during the assessment, and the registered manager assured us improvements would be made to better reflect people’s views and future goals.

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.

There was evidence of joint working with healthcare professionals, including GPs, specialist nurses and local authority teams, to support people’s health needs. Transition planning was handled well, with examples of shadowing and joint working when people first started using the service.
However, continuity was not always reliable. People and relatives reported mixed experiences of staff consistency, with some describing frequent changes in care staff and difficulties when rotas changed. Some relatives told us they were not always informed if care staff were running late or if visits were changed. These issues affected people’s confidence in the reliability of the service.
While the provider had systems in place to support continuity, including handovers and electronic records, these were not always effective in practice. The provider acknowledged these concerns and told us they were taking steps to improve communication and staff consistency.
 

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
The provider had taken steps to meet the Accessible Information Standard. Information was available in different formats, and we saw examples of easy read and pictorial information in people’s homes. People could access electronic records, such as the Nurse Buddy app, to see what care had been delivered.
However, information was not always shared effectively. Some people and relatives told us they were not kept informed about changes to visits, training taking place in their home, or rota updates.
While the provider recognised the need to improve accessible and timely information, including making care plans and complaints information available in easy read formats where appropriate, this was not yet consistently in place at the time of this inspection.

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.
The provider had systems in place to gather feedback, including a complaints policy, surveys and quality assurance visits. Records showed complaints and compliments were logged, and we saw positive feedback from professionals, such as a dentist commenting on good oral hygiene support.
However, people and relatives were not always confident their views led to change. Some told us concerns about staffing changes, training and communication were not always responded to, or responses felt dismissive. Not all people were aware of surveys or how to raise concerns, and feedback data was not consistently analysed to demonstrate learning and improvement.
Although people were listened to in some individual situations, involvement was not consistent across the service. The provider acknowledged these gaps and discussed improving how feedback is gathered, responded to and communicated back to people and their families.
 

The provider made sure that people could access the care, support and treatment they needed when they needed it.
An out-of-hours on-call system was in place, and staff told us support was available outside normal office hours. People and relatives reported that communication via messaging applications was often responsive and helpful.
However, people’s experiences were mixed. Some people told us telephone calls were not always answered promptly, and messages were not always passed on accurately, leading to missed or unnecessary visits.
Overall, while systems were in place to promote equitable access, these were not always effective, and improvements were needed to ensure consistent access for everyone using the service.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes.
Staff had completed training in equality, diversity and human rights, and they demonstrated an understanding of the Mental Capacity Act. People were supported to express their identity, including sexual identity, and staff were observed using people’s preferred pronouns.
However, we were not assured the provider consistently monitored and evaluated outcomes for people with learning disabilities and autistic people. While care was often compassionate and respectful, outcomes were not always clearly reviewed to ensure people experienced the same quality of care and achieved positive results over time.
The provider recognised the need to strengthen how outcomes are monitored and used to reduce inequalities and improve experiences for all people using the service.
 

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 and, where appropriate, their relatives were not consistently supported to plan for important future changes in their lives. Although future planning and end-of-life care were discussed at initial assessments, this was not always reviewed or documented if people chose not to engage at that time.
Care records did not consistently show ongoing conversations about future wishes, changing needs or long-term goals. This meant people’s preferences for future care and treatment were not always clear or up to date.
These concerns were discussed during the inspection, and the provider assured us they would improve how future planning conversations are revisited, recorded and reflected in people’s care plans.