Elite 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 changed to requires improvement. This meant people’s needs were not always met.

This service scored 43 (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 and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Although people felt they received person-centred care from staff during their care calls. We found care plans did not include person-centred information people were not actively involved in planning care that met their individual needs.

The care plan documents we reviewed had sections which were intended to fully reflect people’s physical, mental, emotional and social needs. However, we found these were not completed fully or were left blank and we found no evidence of input from the person or those close to them. Most of the care plans we reviewed, contained very little information about the person. We found no evidence people’s preferences for their care and how they liked their care to be delivered had been meaningfully recorded.

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.

Care documents required improvements. They were not detailed and not fully reflective of people’s known health conditions and support needs. This posed a risk when people were moving between services, such as during hospital admissions, where clear, accurate information may be needed or when the ambulance service attend people in their own homes. We found 2 care plans were dated 2020 and 2022 and therefore, improvements were also needed to ensure reviews were completed fully and regularly, and updates were accurately recorded in people's care plans.

Care was delivered by a small and consistent group of staff, which supported continuity and helped people feel comfortable with those providing their support.

The provider did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

No examples were provided to show information had been given to people in a person-centred way, or in a way they could understand. The management team told us no-one using the service required information to be presented in a personalised way.

The management team were not aware of the Accessible Information Standard (AIS). The AIS requires services to provide information in accessible formats and provide communication support to ensure people can understand and communicate effectively during care delivery. However, when we spoke with staff, they told us 2 people had communication difficulties due to their dementia. Another person required their information provided in a specific written format to enable them to read it. We found their care documentation was not provided in this way and they did not find it easy to communicate over the telephone; however, we found no information recorded about this need in their care plan. We later communicated with this person in their preferred format via email in order to gather their feedback about the service. We will also provide this inspection report in their preferred format.

We also found the management team were not aware of the data protection requirements in relation to sharing information about people via mobile phones and messaging applications. We signposted the management team to ensure they were sharing information in line with UK legislation around protection of people’s data.

We supplied the management team with a letter to explain to people we would be telephoning them to gain their feedback and asked them to distribute the letter to the people who were receiving a regulated activity (10 people). However, this was not actioned, and people had been unaware we would be contacting them.

The provider did not make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not involve people in decisions about their care or tell them what had changed as a result.

We found no evidence the management team had gathered feedback from people who use the service to address any issues and improve the service. There was no information recorded in care plans that people had been involved in formulating, writing or reviewing their care plans and people did not tell us they had been involved with this.

We reviewed copies of care review records completed by the management team; however, these were mostly blank or contained minimal information. In the care plans we reviewed, we found no evidence these care reviews had led to any changes or updates. People confirmed with us they did not have regular discussions about their needs and current care delivery; staff only filled in forms within a file in the property. Comments from people about discussing their care plan included “No, at the beginning, but not recently they [staff] just fill the forms in and go”, “On occasion” and “No, they [staff] just fill it in [file].” We also asked people if anyone from the service ever asked them if they were happy with the care they were receiving and only one person confirmed this had happened.

We also asked people if they knew how to complain and if they had ever complained. Five people told us they had never complained; however, 2 people told us they had complained when staff had not turned up to their care call. One person told us they would complain to staff and another person told us they would call the office or their social worker to complain. The management team told us they had not had any complaints. As stated elsewhere within the report, there was no evidence of actions taken when care calls had been missed.

The provider did not always make sure people could access the care, support and treatment they needed when they needed it.

We were not assured staff had received sufficient and robust training and care plans did not contain information for staff about how to recognise when people may be unwell and when to refer people to health professionals. People did not have specific care plans in place to provide guidance to staff on how to safely support them with some diagnosed conditions such as risk of skin breakdown. We found no impact on people during our inspection; however, there was a risk staff would not always recognise signs of deterioration and when to refer people to other health professionals.

We had concerns about the on-call system in place as staff had reported to us that they could not always get hold of someone when they required assistance during a care call. This impacted on staff’s ability to gain support for people when they needed it or during an emergency.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

We were not assured staff had received appropriate training to ensure they were alert to discrimination and inequality that could disadvantage different groups of people using their service. Staff were not able to describe to us what they knew about equality characteristics and the MCA. People’s care plan entries did not evidence how the service had considered people’s protected characteristics and made reasonable adjustments to support equity in experience and outcomes.

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.

Although there was a section within care plan documents that related to peoples wishes at the end of their life, we found “N/A” had been recorded in every care plan we reviewed. This demonstrated the service had not ensured people had been actively involved in making decisions about their future care. The management team told us they did not provide care to people who required palliative care; however, they had not considered a person, who was already receiving a service, may then require end of life care in the future.

Staff had not received any training in end of life care and there was no policy provided to us in relation to end of life care delivery.