Expectation Care 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 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.
People and their relatives told us they were involved in the development of their care plan and had attended reviews of their care and support. People also told us they had access to the electronic care planning application to view their notes and files. One person told us, “That’s right. A care plan, yes. Review, yes, I think about every 6 months and they recently came – I think it was the end of the year. It’s online. I have the App.”
However, as previously stated in this report, care plans did not always evidence the views or involvement of the person.

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 had the same familiar carers that knew them well. The provider worked alongside people’s relatives when it was appropriate. Staff understood people’s cultural needs and the diverse communities which they served. Where people wished, they were supported to access their faith, dress in cultural garments and eat traditional food favourites.
However, care plans did not always include the views of people where appropriate, and risk assessments did not always include sufficient information to enable staff to understand the health needs of the people they support.
 

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.
One relative told us, “Yes, they are very good at telling me things if they find something that concerns them – mark on the skin, red patch. I have the App…It shows who was there and their notes. The care company send me any information about what is going on, keep me up to date.”
Another relative told us, “I would be in constant contact with the live in carer and visit every day. Communication was brilliant, and with the office, they were fantastic. I would send a message, and they would always come back to me with information if I needed it.”
The registered manager advised they used to support a person who was visually impaired and their speech was impaired, so they were unable to vocalise their needs. They told us how they had put together a full, personalised pictorial chart so they communicate when they were in pain, needed the toilet etc.
 

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. However, staff did not always involve people in decisions about their care or tell them what had changed as a result.
As previously stated, there was no evidence in 1 person’s care plan that they had been provided with all the information to make an informed decision about a restriction on their movement. Also, no mental capacity act assessment had been completed.
Not all complaints had been recorded on the complaints log and when a complaint had been raised it wasn’t clear when it had been responded to.
However, people told us that they felt comfortable raising a concern. One person told us, “I am in regular contact with them [staff] and if there’s anything I wanted, I could call the boss any time of day or night.”
Another told us “It has been fine. I can get through to them any time and if I send a text message they get straight back to me.”
Another told us, “In the very early days …I did complain and they took note of that and they do it a different way now…They rectified it within a couple of days.”
 

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.
Care plans referred to referrals made to professionals. However, either the referrals were not actioned, they were not made in a timely way, the outcomes were not recorded or there was no chasing up when concerns escalated. This was for people who may face barriers when accessing services.

However, people generally found the care to be reliable and flexible.
 

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.
Appropriate documentation, liaison with other professionals and strategies for people with anxiety, agitation, at risk of self-neglect and with complex health needs was not always in place.

However, staff received training in equality and diversity. This was reflected in discussions with staff.
 

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.
At the time of this assessment the provider did not support anyone who was in receipt of end-of-life care.
There was a lack of detail in people’s care plans about planning for the future.
However, people did tell us that staff supported them to fulfil their goals including greater independence. Staff also completed end of life training.