Callquest For 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 that the provider met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 operate robust systems to ensure people were at the centre of their care and treatment choices.

The provider had not always regularly reviewed people’s care records to ensure they contained up-to-date assessments and detailed guidance that was personalised to support staff to meet people’s needs. For 1 person we found their profile had not been completed although the form stated at the top it was an important source of information and helped to establish a good relationship.

Despite this, the small staff team providing care knew people well and how to meet their needs, there was a risk new or agency staff might not know how to meet people’s needs or in the way they preferred. The provider took action following our assessment to review and add some personalised information to people’s care records.

Feedback from people and relatives was that staff knew them well and they received person-centred support. A person gave an example of their morning care routine and how staff provided this in line with their preferences for washing.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Records of people’s care were not always complete such as some risks were not assessed and care plans lacked detailed guidance on how to meet people’s needs. Daily notes did not always reflect the care that staff and people told us they received such as around catheter care or checking skin integrity. Daily notes were not always contemporaneous to show the actual start or finish time of calls. These issues meant the provider could not demonstrate that people received care that met their needs and lack of guidance meant there was a risk people would not receive continuity of care although people and relatives were positive about the small staff team and felt this gave them good continuity.

However, people and relatives told us staff responded to changes and liaised with external professionals when required. For example, staff contacted district nurses and GPs when concerns arose, such as catheter issues or suspected infections.

The provider shared information with people in a way they could understand, although formal systems for communication were limited.

People told us staff explained what they were doing and communicated clearly during care. A person confirmed staff informed them when items such as creams were running low so they could request more.

People’s care records showed their communication needs had been assessed and accounted for. At the time of the inspection people did not have specific communication needs which required staff to adapt their approach

The provider told us people’s care was regularly discussed with them during their care calls to ensure people’s needs were being met and ask whether any changes were required.

The provider made it easy for people to 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.

The provider had policies in place, including a complaints policy that clearly outlined how to raise concerns and expected response times. People and relatives generally felt able to raise concerns and said requests were acted on. A person told us, “If I have asked for things, it’s been done.” A relative said, “My [loved one] has not complained.”

People were listened to in their day-to-day care, but opportunities for formal involvement were limited. Staff told us they regularly checked with people that they were happy with their care and asked if anything needed to change. Daily records showed staff seeking consent and asking for feedback about care delivery.

However, there was limited evidence of structured involvement in service development. People and relatives reported they were not routinely asked for feedback or involved in formal reviews. Survey processes appeared to have been introduced shortly before the assessment and were not embedded in practice.

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

People received care at planned times, and feedback indicated staff were generally reliable and responsive. Where delays occurred, staff usually informed people. The service worked flexibly to accommodate people’s circumstances, such as adjusting care when families were unavailable and supporting changes in care packages.

The provider supported people to have equal access to external services and liaised with pharmacy’s, GPs and district nurses to advocate for people’s needs.

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 worked with other professionals to ensure people’s needs were met such as working with district nurses around people’s catheter care or pressure care.

People and relatives described positive experiences of care. A person told us staff had supported them through difficult times and had provided both practical and emotional support.

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.

Care plans and risk assessments were not regularly reviewed or updated to reflect changes in people’s needs, with long gaps between reviews identified. This meant the provider could not demonstrate a proactive approach to planning for people’s future care.

There was limited evidence of advance care planning within care records. Key information such as end-of-life preferences, DNAR (Do Not Attempt Resuscitation) decisions and long-term health planning was not consistently documented. We raised this with the registered manager who took action following the assessment to approach these conversations with people and their relatives and contact relevant professionals where required.