Selective Care

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 the provider met people’s needs. At our last inspection this key question was rated good. At this assessment the rating remains good. This meant people’s needs were met through good organisation and delivery.

This service scored 79 (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 told us that they had a care plan in place and that care was reflective of their needs. Comments included, “I have a care plan and get help with everything I need” and “They (staff) normally stay for the allotted time and cover all the duties. They are prepared to do extra if needed.”

People’s care plans included information to reflect their physical, mental, emotional and social care needs. Care plans also reflected principles of positive behaviour support (PBS). This helped to identify how people’s behaviour was communicating their needs and how staff could create an environment to minimise distress. Staff understood the principles around PBS, which helped to ensure care plans reflected the care people received.

We reviewed 4 people’s care records and found that care visits were carried out at consistent times and tasks completed were in line with people’s care plans.

People told us they had consistency in their care. They said they received their care calls at agreed times, from teams of staff whom they had built positive working relationships with. People told us that they were informed about changes in their care, for example, if staff were running late or if alternative staff were allocated.

The registered manager had planned care rotas to ensure that people had appropriately sized care teams, this helped to ensure there was sufficient cover from familiar staff. The registered manager told us larger staff teams reduced risk of people becoming too reliant on individual members of staff. Staff told us they had sufficient travel time between care calls. This helped to ensure they arrived at planned times.

The registered manager had a good understanding of the service’s capacity and had made responsible choices about the number of care packages they provided. They told us they considered staffing levels and geographical planning when assessing the viability of new referrals. This helped to ensure that any increases in the size of the service were planned carefully and safely.

The provider was exceptional at developing appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider had gone to great lengths to ensure that information could be provided to people in a format they understood. They had invested in technology which enabled them to translate service user guides and care plans into different languages. This had helped ensure every person could fully engage and participate in their care planning and consent to their care. Where people spoke limited English, the provider had designed flash cards with key phrases in native languages. This helped to facilitate effective communication, for example, helping staff to gain consent to care tasks.

In another example, one person’s care documentation was translated into their native language. As the person did not speak English, this work was essential in ensuring they took an active role in care in planning and being equal partners in all matters related to their care. The registered manager told us this had been fundamental in overcoming barriers around communication and ensured care was tailored to the person’s needs.

The provider conducted assessments of people’s sensory needs. They had identified when any adjustments to meet communication needs were required. The provider was able to produce information in adapted formats, such as large print, which helped people to access information and correspondence. The provider had arranged for people to have access to their electronic care planning system. This meant that people could see their care plans, review care notes and see upcoming planned care visits. This helped to ensure people were fully informed about their care. Where people struggled to access information in digital form, the provider made efforts to promote effective communication in alternatives ways. For example, through providing paper-based rotas or meeting in person to relay essential information about care.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. The provider involved people in decisions about their care and told them what had changed as a result.

People told us they had regular contact with senior staff, who were responsive to their feedback and receptive to their requests about how to improve care. For example, one person told us how they raised an issue about a care call time needing adjusting, which was actioned by senior staff.

The provider had policies and procedures around handling complaints and gaining feedback around care. Senior staff regularly sought people’s feedback through telephone and in person reviews, where people were able to raise any issues which were important to them. They also sent out regular quality assurance questionnaires to gain feedback about care. Results of most recent quality questionnaires reflected that people were happy with the overall standard of care and consistency of staff. Records of complaints received demonstrated the provider took an open and transparent approach. They had used complaints as an opportunity to reflect and improve on the care provided. For example, the provider had helped staff to improve their cooking skills in response to a complaint raised by a person about the support they received.

The provider made sure that people could access the care, support and treatment they needed when they needed it. The provider understood the barriers that people may face preventing them accessing care and support. People’s care plans detailed people’s communication needs, cultural beliefs and protected characteristics. Staff had received training in equality and diversity, which helped to ensure they had an awareness of potential inequalities and how people could overcome them. For example, the provider had systems in place to remove barriers around language by providing people with information in an accessible format. This helped protect people’s rights and promote their choices.

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 provider actively sought people’s feedback and used it to improve their experiences and outcomes. The provider had worked with people and professionals to improve outcomes in relation to healthcare. This included work to improve information sharing around people’s healthcare needs. This meant that people receive coordinated and effective care.

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.

The provider had received compliments from relatives and professionals around end-of-life care staff provided. This included positive feedback around the continuity of care, engagement with professionals and flexibility around how care was organised. The registered manager told us they were proud of being able to support people to stay in their own homes if they wished. They told us that one of the service’s biggest achievements was the small number of people who had to move to residential placements towards the end of their life. The registered manager met with people to discuss their future wishes and document any advanced decisions about their care and treatment. This helped to ensure that care was reflective of their needs.