Holistic Care UK

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 this inspection the rating is Requires Improvement. This meant people’s needs were not always met through good organisation and delivery.

We found the provider to be in breach of 1 legal regulation relating to Person-centred care.

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 make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.Care records had not been consistently reviewed or updated.

There were no person-centred care plans, risk assessments or management plans in place for people living with Parkinson’s disease, medicines, dementia, diabetes, mobility and falls, communication, environment and fire. Staff lacked understanding of dementia types and Parkinson’s disease and how these conditions impacted people.

When we spoke to the provider about the people they supported, they did not know what people’s care and support needs or what support was being provided by staff. When they described people’s support, but this was not always accurate and did not reflect the information contained within care plans. This meant the provider did not always have tup to date knowledge about people’s care and subsequently, were not able to check that staff were providing the support required.

Records did not demonstrate people, their relatives, had been adequately involved in creating or reviewing their care plans and risk mitigation plans, incorporating all that was important to them. The provider told us, that relatives were involved, but we could not be assured as there was no documented evidence of this.
 

The relative we spoke with told us they had support from a consistent group of staff. The service worked with other health professionals involved in people’s care such as GPs and district nurses, if required.

Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (AIS). The standard was introduced to make sure people are given information in a way they can understand. The standard applies to all people with a disability, impairment or sensory loss and in some circumstances to their carers’.

People’s communication needs had not always been assessed to identify people individual needs. There was not always clear guidance in place for staff on how to support people’s communications needs effectively.

We were not assured the provider had explored or could provide information to people in alternative formats. This included pictorials or easy to read formats for people who had cognitive impairment and could not communicate effectively. When we raised this with the provider, they told us that they did provide information to one person in large font and a paper copy of their care plan was available in their home. Following the onsite inspection, the provider sent a us a list of tasks staff were required to carry out in large font. No other care records in the alternative format were provided.

Therefore, we did not see that information was provided in a format that people would understand. This meant we could not be assured that the provider did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider told us they had not received any complaints, but there was a complaints log in place and there was also a complaints policy and procedure in place for receiving, handling and responding to comments and complaints. One relative we spoke with told us they knew how to make a complaint and were confident if they needed to, it would be handled appropriately.

People could access the care, support and treatment they needed when they needed it, which included GPs and district nurses. However, there was not a consistent approach to how care was recorded and monitored. We could see no oversight by the provider in auditing and identifying shortfalls to ensure people had access to the care required.

The provider told us, they treated everyone with respect and kindness regardless of their race, religion, gender and sexual orientation. Staff spoke positively about working for the service and told us that they felt supported by the registered manager.

Care records showed that people were from different cultures, and one had followed a particular faith. However, the provider had failed to explore these divers and cultural needs and give guidance for staff on how to support these needs.

Staff had received equality and diversity training.

The provider was not supporting anyone with end-of-life care. We saw there was an end-of-life care plan in place for one person. However, there were no records to show that either the person or their family members had been involved in this. The provider told us, that they would meet with the other person and their family and discuss putting an advanced care plan in place.

This person’s care plan documented they had a ‘DNAR’ form in place. This wasa medical order that indicates a person’s wish to ‘Do Not Attempt Resuscitation’. However, there was no copy of this form in the person’s care records and no information as to where this form was situated in the person’s home, should emergency services need to attend in a medical emergency. We asked the provider for a copy of the form as well as where in the person’s home the form was kept. The provider did not know where it was kept and did not provide us with a copy.

Staff had received training in end-of-life care.