Spire Homecare Limited

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 the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

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 did not always make sure people were at the centre of their care and treatment choices and they did not always decide, in partnership with people, how to respond to any relevant changes in people’s needs. This meant people did not always receive the most up to date support in line with their changing needs.

Six out of eleven people told us the service was ‘ok’. Seven out of eleven people told us they had not seen their care plan. Comments included “It would be good if I had [seen it] because staff would get to know me a little more” and “If I was involved with my care plan, I think newer staff would support me better”. However, people did tell us that they were happy with the staff who had been employed by the provider for a longer period of time as they knew them and supported them well.

During the assessment, the provider shared some examples of person-centred care. Several stories demonstrated they were committed to supporting people in a holistic way. For example, one person was supported to access the community to achieve a life-long ambition. Another person was supported to overcome their anxieties and access the community. The person told us the impact of being able to access their community was “uplifting and made me feel like a part of something”.

The provider understood the diverse health and care needs of people and their local communities. Care was joined-up, flexible and supported choice but not always continuity of staffing.

The provider demonstrated a clear understanding of people’s diverse health and care needs and worked collaboratively with professionals to ensure continuity among stakeholders and flexibility in care.

Leaders and staff maintained open communication channels with GPs, occupational therapists, social workers, mental health workers and pharmacies, enabling timely interventions and coordinated support. One person told us “Staff have come with me to my health appointments which I have found to be really helpful and considerate”.

Leaders gave examples of proactive contact with professionals when people’s needs changed. This included supporting an individual through a referrals process to access additional support and working closely with mental health teams to arrange ongoing support for another person’s well-being.

This integrated approach meant people received joined-up care that supported choice, continuity and improved wellbeing.

Relatives and people felt if they needed to contact the office, they were always able to speak to someone without a long wait time. This was reflected as a positive experience.

The provider did not always ensure people and their relatives had access to clear, timely and accessible information about their care and support. For example, reviews were not always routinely completed with people. This meant people did not always have the opportunity to discuss their support or raise any concerns. The provider liaised with commissioners and stakeholders to ensure people received regular local authority service reviews. They said any changes identified were communicated promptly.

Some care plans we viewed lacked detail and information. For example, one person’s care plan stated “staff need to check the device and replace batteries” but there was no further guidance on how staff should help with this task. Another person’s care plan stated “staff to be aware of the emotional impact of rushed and negative interactions” but there was no information provided in the care plan to identify what action staff should take when supporting the person. This meant important information about people was not always clear and accurate, and information lacked detail. We spoke to the provider about this who assured us they would make changes to care plans.

However, the provider used multiple communication methods to meet individual needs. This included phone calls, printed materials, and digital updates. For example, one person found it easier to read information from the provider. They said “The provider has written to me in the past regarding events and get togethers. I found this useful because they know that if they told me in a phone call, I would forget”.

The provider did not always seek feedback from people and their relatives to understand their experiences and improve care delivery and did not always listen to people.

Although we saw the provider used a range of methods, including phone calls, surveys and informal coffee mornings, to gather feedback and involve people in discussions about their care, some people we spoke to raised concerns regarding staff punctuality. Comments included “my carer was late and I spoke to the boss about this”. However, despite raising the issue, it was not resolved as the carer was late the following day and “I spoke to the office [about a concern] and the office spoke to the carer who said they did not do it. That was it”. The person told us that this made them feel like they were not listened to.

Most people we spoke to told us they had not received a recent survey, and some said they were not routinely involved in reviewing their care plans. This meant opportunities for people to influence decisions about their support were missed.

Despite this, some people said they felt listened to when they contacted the office and staff responded promptly to issues raised. The provider assured us they were implementing improvements to ensure people’s voices were consistently heard and acted upon.

The provider did however demonstrate a commitment to listening to people during assessments by actively involving them in discussions about their health, care, and communication needs. Before starting the service, leaders carried out detailed assessments that included conversations with individuals and their families to understand what mattered most to them. This approach ensured that care planning was not only based on clinical requirements but also reflected personal preferences and aspirations. For example, during one assessment, the provider identified additional support needs for family members and signposted them to relevant services, showing responsiveness to the wider context of people’s lives.

The provider made sure that people could access the care, support and treatment they needed when they needed it. For example, the provider worked with a public organisation to ensure a person who used a wheelchair had fair access to services. With this joined up working approach, the person was able to enjoy a life that was free from barriers and discrimination. The impact on the person was that they enjoyed accessing the community with their friends and family and did not have to worry about accessibility.

Assessments covering the accessibility of a person’s home and whether any adaptations, equipment or referrals to occupational therapists were needed, had been completed. The provider ensured that as well as people having access to services such as adult social care practitioners, family members also had equal access to requesting social workers. The provider worked to ensure people and their relatives received a fair and equitable service from stakeholders.

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 had completed equality and diversity training and respected each person as an individual. At assessment stage, people were involved in developing their support plan based on their own wishes. For example, within one assessment, the provider identified a person would benefit from mental health support. The provider ensured this was arranged and worked closely with partner organisations to maintain continuity and follow-up, so the person’s needs were fully met.

People told us they were supported to access services to meet their healthcare needs. Comments included “My rights are promoted” and “I can share my thoughts and concerns with the office”. This meant people felt empowered to express themselves, even when wanting to talk about something that was not right.

People were not always supported to plan for important life changes. This did not always allow them enough time to make informed decisions about their future, including at the end of their life.

The provider had some end-of-life care planning documents in place for people, however these were inconsistent. For example, not all care plans included people’s wishes or decisions about end-of-life care. And did not document if the person had chosen not to discuss or make a decision in relation to this, leaving gaps in planning for important life changes.

Not all staff had received end of life training. As a result, people may not have had the opportunity to plan for important life changes, including end of life care, in a timely and person-centred way.

Staff could not confidently talk about people’s wishes for the future. This included whether they wanted to go to hospital for further treatment or whether they wished to remain at home. Staff told us the information would be in the care plan.