Elite Care 24/7

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 61 (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 involved people in decisions about their care and treatment. However, records were not always sufficiently detailed or consistently reflective of people's individual needs.

People told us staff knew them well and sought their views about how and when they wanted to receive support.

Where possible, staff were matched with people based on their preferences and choices.

However, care records did not always provide staff with clear guidance on how care should be delivered in line with people's assessed needs and preferences. For example, we found that 1 person's support plan did not contain detailed instructions for staff, despite them having complex care needs.

Where people were unable to fully participate in decisions about their care, the provider consulted with their relatives or representatives to help ensure their views and preferences were considered.

People told us their needs were regularly reviewed and that changes were made to call times when requested. One person said, "One of the managers came to see me before the care started and asked me what I needed help with. They made sure I had a female carer, as this was important to me."

Staff told us they informed the registered manager of any changes in people's needs so that care records could be reviewed and updated accordingly.
 

The provider demonstrated an understanding of people's diverse health and care needs, supporting joined-up, flexible care that promoted choice, continuity and positive outcomes.

Most people and their relatives told us they had developed positive relationships with staff over time. People described staff as caring and familiar with their individual needs and preferences.

Staff gave examples of supporting people to attend appointments within the community and liaising with healthcare professionals when they identified concerns about a person's health or wellbeing.

We saw evidence that the service supported people to access routine healthcare appointments, including dental, chiropody and optician services, helping to maintain their health and wellbeing.
The provider had arrangements in place to respond to emergencies.

Staff told us they would remain with people when necessary to ensure their immediate safety and wellbeing. The provider could also arrange additional support through a rapid response approach when required to meet people's changing needs.
We found people's visits were generally delivered on time and as planned. The provider used an electronic call monitoring system with real-time alerts to identify late or missed visits. The registered manager told us they investigated any alerts and took action where needed.

We saw evidence of this and noted measures had been implemented to reduce the risk of similar issues occurring again.
 

The provider supplied appropriate, accurate and up-to-date information in formats tailored to people's individual communication needs.

The provider's service user guide contained information about what people could expect from the service, including relevant contact details and information about how to raise concerns.

The registered manager told us this information could be provided in alternative formats, including large print, easy-read versions and different languages, to help ensure it was accessible to people.

Staff described how they adapted their communication methods to meet people's needs. This included using pictures, written information and other communication aids where appropriate to support understanding and involvement in care decisions. The registered manager also explained they sought to match people with staff who spoke their preferred language wherever possible, helping to promote effective communication and positive relationships.

Relatives told us staff maintained regular contact with them, providing updates by telephone and sharing information about changes in people's needs or any concerns regarding their wellbeing.
 

The provider did not always make it easy for people to share feedback, raise concerns or be fully involved in reviewing and developing their care and support. Care records were not always reviewed in a timely way to ensure they remained up to date and reflected people's current needs.

Most people we spoke with told us they had not needed to make a formal complaint. People felt able to raise any day-to-day concerns with care staff, who would then communicate these to the office. One person told us, "If I am concerned about anything, I tell the carers and they let the office know. I don't have to speak with the manager."

Relatives also spoke positively about their relationships with care staff. One relative said, "The carers are brilliant; I don't have to speak to the office staff. They moved offices a long time ago and I didn't know." This suggested some relatives had limited direct engagement with the management team.

The registered manager told us regular reviews of people's care were undertaken, and we saw evidence that some reviews had taken place.

However, we found several support plans had not been formally reviewed for more than 12 months. This meant the provider could not always be assured that care records accurately reflected people's current needs, preferences and desired outcomes.

The registered manager explained that following the introduction of a new electronic care planning system, all people using the service would receive a comprehensive review of their care. They told us people and, where appropriate, their relatives would have access to the system, supporting greater involvement in care planning and review processes.
 

The provider worked to ensure people could access the care, support and treatment they needed in a timely and equitable way.

The provider told us there was an on-call system available outside of normal office hours, which could be accessed by people using the service, relatives and staff when support or advice was needed.

People told us staff supported them to access healthcare services when required, including making appointments with healthcare professionals such as GPs.

Electronic care monitoring data, feedback from people and discussions with staff indicated the service was reliable and responsive to people's needs. Records showed there had been no missed visits during the period reviewed, and most care calls were delivered within the agreed timeframe.

People spoke positively about the service and told us they received the support they needed when expected. This helped to promote continuity of care and reduce the risk of people experiencing delays in receiving support.
 

The provider did not always have sufficient information recorded to demonstrate how the needs of people who may be at greater risk of experiencing inequalities were consistently identified, monitored and responded to.

We saw examples of people with complex needs receiving compassionate and personalised support. Relatives spoke positively about the care provided and told us staff understood people's individual needs and preferences.

However, we found gaps in care documentation. For example, some records did not contain detailed guidance for staff on how to support people with complex needs or behaviours, and risk management information was not always clearly documented. This meant the provider could not always demonstrate that care was planned and delivered consistently in a way that promoted equitable experiences and outcomes for all people.

We discussed these findings with the provider, who acknowledged the issues and took immediate action to review and strengthen care planning and risk management documentation
 

The provider could not always demonstrate that people's future needs and preferences were reviewed and planned for proactively, as reviews of care plans and risk assessments were not always evidenced.

We found that reviews of care plans and risk assessments had not always been recorded consistently. This limited assurance that changes in people's needs, preferences and circumstances were regularly considered and reflected in care records.

At the time of our inspection, no one using the service was receiving end-of-life care.
We saw that some people had completed Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions and Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) forms. These documents were available to staff and helped ensure people's wishes and preferences for their future care and treatment were known and respected.

The registered manager told us that, as part of the transition to the new electronic care planning system, all care plans, risk assessments and advance care planning information would be reviewed to ensure records remained accurate, up to date and reflective of people's current wishes and needs.