Amber Home Carers Surrey

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• 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.

The service was in breach of legal regulation in relation to person-centred care.

This service scored 57 (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.

The quality of people’s care plans varied. Some people’s care plans contained only basic information about their needs with generic statement made rather than personalised information and guidance for staff. The format and content of information varied which made it difficult to know where to look for information. The registered manager acknowledged that improvements could be made in relation to how care plans were written and assured us these concerns would be addressed.

In other instances, we found that people’s specific preferences and care needs were referred to throughout their care records and staff had the guidance they required to support people in line with their wishes.

The provider did not always understand the diverse health and care needs of people and their local communities, so care was supportive of choice and continuity.

Information in relation to people’s specific health and social care needs was not always recorded and for some people it was difficult to understand why they were in need of support. Where health concerns were recorded, this did not always provide staff with guidance regarding how to support the person or identify signs of a deterioration in the person’s health or well-being. When people had spent time in hospital, the reason for this was not always recorded to ensure there were no changes to people’s needs.

In other instances, we saw there was good communication between health and social care professionals. Where requests were made to increase or decrease care visits or hours this was actioned without delay. We saw evidence requests and referrals for equipment were made to support people with their independence.

Following our assessment we received assurances from the provider that recording systems were being reviewed to ensure greater consistency in how people’s health and social care needs were recorded.

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

Information within people’s care plans around their communication needs was not always in line with the Accessible Information Standards. Guidance on how people preferred to receive information was not consistently recorded and communication care plans contained the same generic statements for staff to follow. This meant there was a risk people would not be fully involved in planning their care due to not having communication systems which met their needs.

In other areas we found details of people’s needs were recorded for staff such as if people wore glasses or needed hearing aids to assist in their communication.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

We received mixed feedback regarding how the service responded to complaints. One relative told us they had raised a concern regarding the conduct of a staff member. They felt the registered manager had listened and ensured the staff member did not support their family member again. Another relative told us they had raised numerous concerns and although some action was taken, this was not consistent and actions taken to rectify issues were not always maintained.

Records were reflective of the above comments from relatives. We saw evidence of one complaint where the registered manager had worked with the local authority to resolve concerns. However, not all the agreed actions had been implemented which meant the person’s health was not being monitored in the desired way. In other instances, we saw concerns were responded to promptly and in line with the provider’s complaints policy. Records showed people were satisfied with the response.

The provider maintained a log of compliments received from people and relatives. These demonstrated an appreciation for the care and support provided by care staff and the efforts made to build relationships with people and their families.

Following our assessment the provider forward information to show systems had been implemented to monitor complaints.
 

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

The registered manager was aware of the inequalities in care people may face. They ensured that where required, referrals were made to health and social care professionals and that advice given was followed up on.

The provider had an on-call system in place which meant people and their relatives could call to make changes to their care calls, staff could request guidance, and support could be provided in the event of an emergency.

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 received training in equality and diversity and care plans directed staff to promote people’s rights by ensuring they gained their consent prior to delivering care. People’s personal preferences were understood. For example, where people had specified the gender of staff they preferred, this was respected.

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.

People’s care plans did not include information on planning for the future or a record of any discussions held with people regarding their end of life wishes. This meant staff would not have important information to refer to should a person’s health deteriorate.

Staff had completed training on supporting people with end-of-life care. The registered manager told us they had developed good working relationships with the local hospice and community nursing team and worked collaboratively to ensure people receiving end of life care remained comfortable and pain free.