FCNA 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 requires improvement. At this assessment the rating has remained requires improvement.

This meant people’s needs were not always met.
 

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 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.

Feedback from people and relatives showed care was delivered in ways that reflected personal routines and preferences, and survey findings supported this, describing management as approachable. These results indicate people felt listened to and that day to day care aligned with what mattered to them.

When concerns were raised, staff usually took action quickly and most people said the issues were resolved to their satisfaction. This showed that feedback was listened to and led to changes that were tailored to individuals, rather than one off fixes.

The digital record provided near real time visibility of care tasks and observations for families who were onboarded, helping people and those important to them to understand what support had been provided and to spot changes early. People and relatives described staff adapting their approach when needs changed, and managers confirmed that visits or timings were sometimes adjusted the same day to reflect personal circumstances.

However, while lived experience evidence and survey results were positive, the provider did not supply regular, structured review notes or routine care planning updates for all individuals. This meant we could not always confirm how personal preferences and changes were captured and shared across the team in a consistent way over time.
 

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 and relatives described care as generally reliable and consistent day to day, although feedback about timekeeping was mixed, with some experiencing variability in visit times. Evidence from the digital system showed high visit completion rates, stable punctuality, and that people generally received support from a small, familiar group of care workers. These indicators of continuity were reflected in feedback that staff knew people well and responded when their circumstances changed.

There were examples of short notice adjustments being made to ensure continuity when needs increased, such as adding or altering visits the same day, and staff described contacting seniors or the registered manager if unforeseen issues arose. The records also showed isolated instances of external professionals being involved at the right time, such as input from occupational therapy or the Admission Avoidance Team, helping to maintain joined‑up support when people’s needs became more complex.

However, the provider did not submit evidence to demonstrate how information from external professionals, staff observations or family input was brought together to guide longer term planning. As a result, we could not confirm how the service coordinated ongoing adjustments to care or ensured that short term responses consistently translated into updated plans understood across the whole team.
 

The provider did not consistently demonstrate that people received appropriate, accurate and up to date information in formats tailored to their individual needs.

The materials we reviewed did not show that people consistently received the information they needed to understand their care or make informed decisions. Although the digital system allowed families to view visit notes and updates, access was inconsistent; several relatives reported they had not been given login details or onboarding support, meaning they could not see essential information about daily care, changes in needs or missed tasks.

The provider also did not submit evidence to demonstrate how information about changes, such as alterations in health, medicines, risks or equipment, was communicated to people or those important to them. Record keeping gaps, including incomplete assessments and missing follow up documentation, meant staff did not have reliable, current information to share, and people could not be confident that written information reflected their actual needs.

Survey findings showed that while some people felt informed, others reported difficulty accessing care related information or policies. This reflected wider inconsistency in how the service provided updates.
 

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

People and families consistently told us staff listened to them, acted on what they said and responded quickly when they raised concerns or asked for changes to their support.

Feedback showed people felt able to request adjustments to visit times or routines, and staff adapted their approach in ways that reflected individual preferences.

However, the provider did not submit evidence to demonstrate follow up from incidents or near misses, so we could not confirm how feedback or concerns informed planned improvements.

Although day to day involvement was strong, record keeping gaps meant we could not confirm how people were routinely included in formal decision making about their care.
 

People were generally able to access day-to-day care and support when needed; however, the provider did not consistently demonstrate how people accessed additional or ongoing care and treatment when their needs changed.

People and relatives consistently told us staff responded quickly to immediate changes, including falls, illness and unexpected hazards. Digital records showed high visit completion rates and no missed calls, which supported reliable day to day access. Staff also described adding visits at short notice when people required increased support, and managers sometimes adjusted rotas the same day to maintain continuity.

However, the provider did not supply evidence showing how short term responses were translated into planned, longer term access to care. There were no structured review notes or routine monitoring records to demonstrate how risks such as weight loss, dehydration, skin breakdown or repeated refusals of medicines were identified early enough to prompt timely input from health professionals. This limited assurance that people consistently accessed external healthcare when their needs increased.

We did not see clear escalation processes for deteriorating health or emerging risks in the materials submitted. For example, the provider did not submit any evidence to show how concerns identified by staff were monitored, trended or followed up, and there was no evidence of planned discussions with community professionals about ongoing access needs. As a result, access to additional support depended largely on staff recognising issues in the moment rather than on structured systems that ensured equitable and timely escalation for everyone.
 

While individual risks and concerns were monitored, the provider did not consistently demonstrate how information about people who are most likely to experience inequality in experiences or outcomes was identified, analysed or used to inform tailored care approaches.

Survey data supplied by the provider showed notable differences in how some groups experienced the service. People under 65, and those with learning disabilities, reported substantially lower satisfaction scores than others, in areas such as communication, confidence in the service and overall experience. These disparities were not supported by evidence of targeted review, analysis or follow up to understand and address the causes.

The provider did not submit outcome monitoring records, trend information or reviews that could show how differing needs and risks were identified and managed for groups more likely to experience health inequalities. For example, no trend analysis was produced for falls, unplanned contact with Careline, deteriorating skin integrity or repeated medication refusals, events that could indicate emerging inequality in outcomes for particular individuals or groups.

Incident records showed examples where people experienced hazards, refusals or deterioration, but these were not recorded as learning opportunities or linked to any service level review. Similarly, we did not see evidence of oversight or planning to identify whether particular groups, such as people with fluctuating capacity, or those with complex physical needs, required adjusted approaches or additional support.

Based on the evidence submitted, we could not confirm how the provider used structured review cycles to evaluate or address differences in experiences and outcomes.
 

The provider did not consistently demonstrate how people were supported to plan for important life changes, including future care and end of life preferences, in a structured and timely way.

The provider had an Advance Care Planning (ACP) policy that set out person centred principles, expectations for early engagement after changes in health, and the need to review preferences regularly. However, the evidence submitted did not include examples of completed ACP documents, planning meetings, or version controlled records showing that these processes were used in practice. This meant we could not confirm how people’s future wishes were documented, shared or reviewed over time.

Operational records showed that staff and managers sometimes arranged short notice changes to visits, and that external professionals were contacted during acute events (for example, OT involvement to resolve equipment issues). While these actions helped in the moment, there were no structured notes or follow up reviews to demonstrate how immediate responses led to anticipatory plans or clear next steps.

The provider had begun to act on feedback from specific groups, for example, introducing independence goal planning for younger adults. but there was no routine, service wide evidence that future planning was discussed, personalised and re checked alongside clinical risks (such as malnutrition, skin integrity or repeated medicines refusals). As a result, we could not confirm that planning for the future was embedded beyond policy or isolated adjustments.