Caremark Tunbridge Wells, Tonbridge and Malling

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 50 (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 ensure care was planned and delivered in a person-centred way.

While there were examples of care being adapted to individual preferences, systems and delivery were inconsistent, meaning people did not always receive care that fully reflected their needs and choices.
There was evidence that the provider sought to adapt care based on people’s preferences, including adjusting call times and responding to feedback about daily routines.

Staff described delivering care in a personalised way, building relationships with people and adapting their approach depending on their needs and preferences.

However, people and relatives reported that care was not always consistently delivered in a person-centred way. Concerns included, care tasks not always completed as expected and staff not always understanding individual needs.

There were also examples where care plans were not sufficiently detailed or up to date, meaning staff did not always have the information needed to deliver truly personalised consistent care. One person told us, “I asked for a detailed care plan which we got but we haven’t had a review for over 2 years.”

This demonstrated that person-centred care was not consistently embedded across the service and was significantly impacted by variability in staffing and care planning.

The provider generally ensured care was provided. However, continuity and consistency of care were not always maintained, which impacted people’s experience.

Care was generally delivered, and staff described ensuring people received support according to their schedules and needs.

The provider had systems in place to organise care delivery, including rotas, electronic monitoring and communication systems.

However, people and relatives reported a lack of continuity, including, different carers attending regularly with limited familiarity with people’s needs.

There were also examples of delayed or missed calls, which disrupted continuity and impacted people’s daily routines.

While the provider was taking steps to improve consistency, including rota adjustments and recruitment, this had not yet resulted in a consistent experience for all people using the service.

The provider did not always ensure people had access to clear and accurate information about their care. Communication systems were in place; however, people and relatives did not always receive the information they needed to understand or engage with care delivery.

The provider used electronic systems that allowed carers to record care notes, and there was provision for families to access information through digital platforms.

However, people and relatives reported that they did not always have access to key information, including, care plan, visit schedules and updates about care delivery.

There were also concerns about the accuracy of information recorded, with some relatives reporting discrepancies between the care delivered and the notes recorded by staff.

This demonstrated that, although systems existed to share information, they were not consistently effective in ensuring people and relatives were informed and involved.

The provider did not always ensure that people and relatives were listened to or involved in decisions about their care. While opportunities to provide feedback existed, responses were not always timely or effective.

The provider had systems to gather feedback, including surveys, monitoring calls and reassessment visits.

Staff described acting on feedback where possible, including making adjustments to care delivery and care plans.

However, people and relatives reported that, concerns were not always responded to and issues raised were not consistently resolved. For example, some feedback highlighted that emails and calls were not consistently responded to. This meant feedback did not always lead to meaningful changes and systems were not consistently effective in ensuring people felt heard or involved.

The provider generally ensured people could access the service and receive care; however, operational challenges sometimes impacted equitable delivery.
 

The provider supported a mix of private and local authority-funded clients and had systems in place to assess and accept new referrals.

Care was generally provided to people with a range of needs, including complex health conditions, demonstrating that the service was accessible to different groups.

However, administrative challenges meant that access was not always as timely or efficient as expected. For example, it had been highlighted that there needed to be more staff employed at the office. This has been addressed and staff employed to help resolve these issues.

While access to the service was generally maintained, inconsistencies in administrative processes and capacity impacted how effectively this was delivered.

People’s experiences and outcomes were not always consistent, with some people receiving good quality care while others experienced variable service delivery.

Some people reported positive experiences, particularly where they had regular carers and stable support, and described improvements over time.

Staff demonstrated a commitment to delivering good care and supporting people’s individual outcomes.

However, people’s experiences varied significantly depending on factors such as staffing consistency, communication and care coordination.

Concerns raised by people included variability in staff skills and experience and differences in how care was delivered. This meant there were inconsistent outcomes with people using the service.

This showed that outcomes were not consistently equitable across the service, with some people experiencing better care than others.

One person told us, “To be fair the last few weeks the carers have been great and timely. Which has been wonderful.”

The provider did not always ensure effective future planning or review of care. Systems for reviewing care were in place but were not consistently implemented, meaning people’s changing needs were not always identified or responded to in a timely way.

The compliance team had implemented review trackers and prioritised overdue reassessments. Managers also described involving family members and professionals in reviews where necessary and using reassessment to update care planning information.

However, there remained significant gaps in review arrangements. Some people and relatives told inspectors that reviews had not taken place for long periods or did not feel meaningful. The provider’s own records also showed the need to catch up historical gaps in review activity. This meant future planning was not yet a consistent strength and could not always be relied upon to keep pace with changing needs and people’s wishes at the end of their lives.