Jireh Homecare

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 remained good.

Good: This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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.

People received care and support that was tailored to their individual needs from staff who knew them well. One person was non‑verbal and required support to communicate. Staff supported this person using text messages and written communication, which was their preferred method. Staff understood the importance of allowing sufficient time for this form of communication, as it was an essential part of the person’s daily routine.

Staff demonstrated a clear understanding of person‑centred care and the importance of respecting people’s preferences and choices. One staff member told us, “Every person we care for is important to us. It’s all about their needs and their choices. Everyone has different needs and different things they like or don’t like.”

Relatives confirmed staff were attentive and responsive to changes in their family member’s health and took appropriate action. One relative told us, “Carers will contact me when anything happens or changes.” Another said, “The office keeps in touch with me and always keep me updated.”

People and relatives told us they were involved in decisions about care and support, particularly when needs changed. One person using the service told us, “Any decision involving my health and care needs are discussed with myself, my [relative] and the care team.”

Care plans were not consistently person‑centred and did not always fully reflect people’s individual healthcare needs or the support required to promote wellbeing. The provider had identified this shortfall following a recent intervention by local authority commissioners. In response, and working collaboratively with commissioners, the provider reviewed and strengthened its pre‑assessment process.

We saw evidence that care plans and risk assessments for people most at risk had been reviewed and updated. These revised care plans were person‑centred, reflected individual needs and preferences, and demonstrated a clearer focus on promoting people’s wellbeing.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People received continuity of care from a stable staff team. This supported the development of consistent, trusting relationships, as people got to know staff well and staff had a good understanding of people’s individual needs and preferences.

People’s needs were assessed prior to starting with the service to ensure their care and support requirements could be met safely and effectively. These assessments considered people’s physical, emotional and social needs and helped inform care planning to promote continuity from the outset of the service.

The provider worked closely with external health and social care professionals to ensure people received coordinated care when required. Staff described positive working relationships with professionals, such as occupational therapists. One staff member told us this enabled them, with people’s consent, to seek advice and guidance to ensure people received the right care and support at the right time.

The service demonstrated flexibility in responding to people’s changing needs, which supported continuity of care. Adjustments were made when needed to ensure people continued to receive support in a way that met their preferences and needs. For example, when a person experienced a deterioration in their health, care calls were increased and adjusted to provide additional support with personal care, medication prompts and monitoring of their wellbeing. Wherever possible, the same staff continued to provide care to maintain familiarity and reassurance.

Managerial support was available outside of office hours and in emergency situations. There were several examples where managers had provided reassurance and guidance to people, relatives and staff following incidents, periods of ill health or when urgent concerns arose. This helped ensure people continued to receive safe, consistent care and that staff felt supported to manage situations effectively.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Following an intervention by the local authority commissioners, the provider had introduced a new system to review care records. This included the implementation of an electronic recording system designed to meet the needs of the service and ensure care records remained accurate, up to date and reflective of people’s current needs and preferences.

While the system was in the early stages of implementation and required time to be fully embedded, it was intended to support more effective communication between staff and help ensure people received consistent, person‑centred care.

People’s communication needs were considered at the point of initial assessment. The service confirmed that information could be provided in alternative formats where required, including pictorial formats, braille and large print, to support people’s individual needs. People were supported to use Picture Exchange Communication (PEC) cards where appropriate, and staff had received the necessary training to support effective communication.

Relatives told us there was generally good communication between themselves and the service. One relative said, “They phone me. For example, if [person] has been ill or if the paramedics have been called. They keep me informed.”

The provider had developed a service user guide, which included clear terms and conditions in line with good consumer rights practice. This guide was available in large print and could be translated into alternative languages if required, ensuring information was accessible and inclusive.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People were provided with a welcome pack when they first started using the service. This included clear information about who to contact in an emergency and how to do so, along with the names and contact details of management staff. The pack also included the service’s complaints procedure, outlining the different ways people could raise concerns or make a complaint.

We reviewed complaints received by the service and found they were acted upon promptly and responded to appropriately.

People told us they felt listened to and that staff respected their wishes and views. Comments included, “They listen to me and understand my concerns.” People were given opportunities to share feedback through regular reviews and discussions, where they could raise suggestions or identify areas for improvement.

Managers carried out spot checks in people’s homes, which provided regular opportunities for people to discuss any concerns or give feedback about the care they received. In addition, annual satisfaction surveys were sent out to gather people’s views and inform service improvements.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People were able to access the service fairly and without discrimination. Systems were in place to ensure people’s individual needs were identified during the initial assessment process and that appropriate support was offered to meet those needs.

Assessments considered people’s physical health, communication needs, cultural preferences and any reasonable adjustments required. Information was made available in alternative formats, including large print, pictorial formats and could be arranged for different languages, to support accessibility and informed decision‑making.

The service demonstrated flexibility in responding to people’s circumstances, including changes in health or personal situations, which helped to remove barriers to care. Managers worked closely with people, families and external professionals to ensure support was inclusive, responsive and appropriate.

People told us they felt supported to access the care they needed in a way that met their individual needs and promoted independence. Staff were mindful of people who required additional support to access social activities, and assistance was available for people who used wheelchairs.

Managers also worked with health and social care partners to arrange new or replacement equipment where required, to prevent delays or disruption to care. Where equipment was in place, this was clearly documented within people’s care plans to support continuity and safe delivery of care.

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.

Staff knew people well and ensured care was tailored to meet their individual needs. This helped people to have positive experiences of care. People and their relatives spoke positively about the service and told us they felt listened to and involved. Where feedback identified a need or concern, appropriate action was taken to support people and improve outcomes.

Staff received equality and diversity training, which supported their understanding of potential inequalities faced by people using the service. Policies and procedures reflected people’s protected characteristics and were aligned with relevant legislation, helping to ensure care was delivered in a fair and equitable way.

The manager confirmed they actively advocated for people and their relatives during healthcare appointments and funding reviews, helping to ensure people’s voices were heard and their needs appropriately represented.

People had fair and equal access to the support they required. Staff demonstrated a good understanding of people’s cultural, communication and health‑related needs and adapted care accordingly. Examples included supporting people who spoke English as a second language, adapting communication styles, and enabling people to access learning and social opportunities through community‑based activities.

Staff described the organisation as culturally inclusive. One member of staff told us, “People from different cultures, backgrounds and religions work here and we respect each other’s values.” This contributed to a positive environment where people were treated equitably and experienced good outcomes, regardless of personal characteristics or communication needs.

People were 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 were given the opportunity to contribute to advance care planning should their health significantly deteriorate or if they required end‑of‑life care. Where people chose to share their wishes, this information was clearly recorded within their care plans to ensure staff could support them in line with their preferences. Family members were involved in these discussions where appropriate.

Do Not Attempt Resuscitation (DNAR) decisions were in place for some people and were documented appropriately. This helped ensure staff were aware of people’s wishes and could respond respectfully and sensitively in line with agreed guidance.

The provider shared that they have attended funerals for people they had supported, particularly where individuals had no known relatives.

At the time of the inspection, the service was not supporting anyone at the end of their life. However, managers confirmed that staff would have access to appropriate end‑of‑life training should this be required. They also described the advice and support available from district nursing teams and the local hospice, ensuring staff could access specialist guidance to support people and their families effectively.