Coast Community Care

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 made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs. Care was provided in a person centred way, putting people and their wishes and needs first. Care plans were written emphasising what people could do for themselves first, before moving on to the support they needed. People’s life histories were documented in care plans making the documents personal and relevant to the person. People described the support received as being about them, considering their needs and putting them at the centre of decision making. A relative told us, “They always keep her well informed but she does have the tendency to forget. They do put her needs first.” Staff knew the importance of person centred care and told us they always put people and their needs and wishes first.

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 were inconsistencies in feedback from people and relatives about the support provided by health and social care professionals. Whilst some were positive reporting issues being resolved quickly, for example, a person who had an issue with equipment needing a community nurses’ support, telling us the concern was resolved within a day and that care staff followed up with a visit in a timely way. People lived with a range of health support needs including diabetes, dementia, learning disabilities and some with historic substance dependency. Whilst these were recognised and recorded within care plans, the risks associated with these ongoing needs and the joined up approach to meet those needs from the service working with other professionals, was not always in place.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People and their relatives told us that the communication between the service and themselves worked well. They received rotas every two weeks that were only ever changed if staff reported sick. Some people living with short term memory issues liked to be remined which carers were attending. A relative told us, “They do send a paper copy but it can change so she does not always know who is coming. The staff will look on the app and tell her who will be coming in the next visit. All the girls do let her know who she is expecting on the next call.” Some people living with a learning disability preferred alternative means of communication. Some used Makaton, a language program that uses signs, symbols and speech and others preferred using coloured cards and symbols as a means of communicating their needs, feelings and preferences. Staff knew people well and those that supported people living with learning disabilities told us they knew people’s body language and could tell if they were distressed or otherwise in need of support.

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. Feedback from people and relatives was mixed regarding opportunities they had to provide feedback about the service and their involvement in care plan reviews. Some people told us they had been asked for feedback but most told us they had not. There was no formal process of collecting feedback from people. Similarly, most relatives told us they had not been involved in reviews of care plans. People and relatives did however know the process of how to raise concerns and make a complaint if needed. They were generally happy about the response from the service when issues were raised. One relative told us, “If I were to raise a concern I feel like I would get a good response from the team.” A complaints policy was in place and was accessible to everyone. We looked at a recent complaint that had been made and this had been investigated and responded to in a timely way, in line with the service policy.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Although the registered manager reported positive professional relationships with health and social care partners, some people did tell us that the service did not always work in a timely way with some professionals. For example, some people had requested and been waiting for medicines reviews for several months and others were waiting on the replacement of faulty equipment. However, when needed, people were supported to attend some appointments and the service would provide staff to help with this. Some people visited day centres each week and when family members were not available to help, staff would sometimes accompany people to these sessions. People were provided with rotas so they were reassured that their care visits would take place at the times each day that had been agreed.

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. People were treated fairly and the service made sure that everyone had access to and support with, activities, visits and events that were important to them. Within care plans was a ‘task planner’ which gave details of people’s routines and weekly activities. For most of these people were supported by family members but staff did also help with some. A staff member said, “I have client in Eastbourne who likes to go out. We go to the park, sometimes play cards, he has taught me some card tricks.” Another added, “They have hobbies and interests. I sometimes help going with them to college and sometimes church.” Some people living with dementia attended a weekly day centre and staff also helped with this.

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 told us that advanced decisions and choices about care towards the end of people’s lives, were discussed as part of the pre-assessment process. However not everyone, including relatives, recalled those conversations. Care plans had a section relating to end of life care but in most cases these were blank. Comments from relatives included, “No I’ve not talked to anyone about that” and “We haven’t discussed this.” No one was in receipt of end of life care at the time of the assessment. Staff had completed end of life training and most had experience of supporting people at that important stage in people’s lives. Staff were able to tell us the important aspects of care for people towards the end of their lives, one telling us, “We have none now but know it is important to make them as comfortable as possible.”