Tender Loving Care South West

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

This service scored 71 (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 make sure people were at the centre of their care and treatment choices. Staff were not given information about people’s experiences and life histories to help them understand people’s current needs.

People’s care plans contained limited information about their backgrounds and life history. They did not include information known to the registered manager about people’s previous experiences in care. Information about people’s life history and background is important in supporting staff to build relationships, during initial care visits and to help staff understand how people’s experiences may affect their current needs.

Ccare plans had recently been reviewed and updated. These documents included clear guidance for staff on the support each person required during each care visit. These updated care plans were available in people’s homes. Staff told us they had the information they needed to meet people’s needs. Staff comments included, “The care plans have all the information I need in them, MAR charts, body maps, everything” and “[The care plans] are in the folders in people’s houses, so we have the information we need”.

During visits to people’s homes, we saw care was provided as detailed within people’s care plans. People were aware of these documents and signed them to record their consent to the planned support.

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.

The service endeavoured to support people to live at home and remain as independent as possible. People were able to vary the timings of planned care visits in response to their social needs and records showed there were systems to ensure time critical support was provided as required.

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

Staff communicated with people effectively and varied how they presented information to people to aid their understanding. One person we visited was hard of hearing but did not like using their hearing aids. Staff respected this choice and ensured they faced the person to enable lip reading and raised their voice appropriately when talking with this person.

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.

The registered manager visited people regularly in their own homes to gather feedback, review care plans and ensure the service was meeting people’s needs. Records of these reviews showed people were happy with the support they received and that changes were made in response to any issues reported. The service regularly received praise and thankyou cards from people’s relatives. One recently received card thanked staff for their compassion and read, "You became friends and part of my family too!"

People told us they were comfortable contacting the registered manager to discuss any issues or concerns. Information on the provider’s complaint policy was included in people’s welcome packs. When complaints were made, they were investigated and addressed.

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

Ther service worked with NHS colleagues to ensure people received the support they required. The registered manager told us they felt well supported by partners who responded promptly to requests for advice.

One person told us they had been fearful of a planned medical intervention and had raised this with staff. As a result, the registered manager had visited to explain what was proposed. The person told us, “[The registered manager] came here and we talked about it and that did help, getting it off my chest”.

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.

The service worked flexibly with people to agree schedules of visits that reflected people needs and preferences. Care visits were normally provided on time and people told us they had never experienced missed care visits. During our observed visits, staff provided support at a relaxed pace taking time to chat and joke with people. Where visits overran, because of emergencies, there were systems to inform people their carer had been delayed.

Staff understood people’s communication needs and at the end of care visits informed people who was due to provide support during their next visit.

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’s wishes and preferences in relation to support at the end of their lives had been accurately documented and were respected by staff. Where people had made decisions in relation to resuscitation, the service ensured this information was readily available to emergency workers within the person’s home. The registered manager recognised the importance of supporting people to die at home if they wished.