Care Outlook (West Wickham)

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 the last inspection the rating for this key question was Good. At this inspection the rating has changed to requires improvement. This meant people’s needs were not always met through good organisation and delivery.

We found the provider to be in breach of 1 legal regulation relating to Person-Centred care.

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 did not always ensure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.Care records had not always been consistently reviewed or updated.

There were not always effective systems in place to make sure people, and their relatives were involved in regular care plan reviews. Although the manager told us regular care reviews were taking place, we received mixed feedback, from people in relation to having a care plan or regular care reviews.

For example, one person said, “Care plan? I don’t know about reviews.” Another person said, “I have never seen a care plan and they must log in and out on their phones. I don’t know what they write about me, and I’m not included in discussions about my care.” A third person said, “Not seen a care plan for a while.” A fourth person said, “I think I was assessed at the beginning from the office, but I have never seen a manager since.” However, one person said, “I have seen the care plan, and they seem to follow up on it. I feel included in the care, and they ask my opinion” and a relative said, “Reviews of [person’s] care are carried out by the manager.”

Staff told us they had access to people’s care plans electronically by using the provider’s homecare app on their mobile phone. However, staff informed us that mobile phones sometimes were slow, took time to load or could not access care plans at all. This meant information was not always promptly available when staff needed to check tasks, care plans and risk assessments. One staff member said, “Care plan folder no longer in the house, it’s all on phone. Sometimes this causes problems, as we can’t connect.” Another staff member said, “File on phone, phone can be slow.” One person said, “No access to the records that are held on the phone app.” The provider had not recognised this risk and has not put mitigations in place should this issue arise while staff were caring for a person.”

Overall, people and relatives told us they had support from a consistent group of staff and rotas confirmed this was the case. The service worked with other health professionals involved in people’s care such as GPs and district nurses.

Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (AIS). The standard was introduced to make sure people are given information in a way they can understand. The standard applies to all people with a disability, impairment or sensory loss and in some circumstances to their carers’.

Some people did not always have information provided in a format they would understand. Where people had specific communication needs, there were not always effective management plans in place and there was not always clear guidance in place for staff on how to support people’s communications needs effectively.

We were not assured the provider had explored or could provide information to people in alternative formats. This included pictorials or easy to read formats for people who had cognitive impairment or had a learning disability and could only communicate in specific ways. When we raised this with the manager, they told us they would rectify this shortfall.

After inspection the provider told us that they have arrangements to translate documents into languages other than English and in other formats if required.

Four people or their relatives told us they did not have a copy or access to their care plans. One person told us, “The care plan is on the carers’ phones, we don’t have one”. This meant not all people using the service were supplied with accurate and up-to-date information, and especially in format according to their individual needs.

After the inspection the provider told us that people could have access to the electronic care plan if they request this or can have a paper copy of the care plan.

The provider’s complaints process to handle complaints effectively was not always robust.

There was a complaints policy and procedure in place for receiving, handling and responding to comments and complaints. Although not everyone we spoke with could tell us about the complaint’s procedure, overall people told us that they would speak to a member of care or office staff if they had a complaint. The provider told us that each person or their relative received a service user guide which outlined the complaints procedure when they joined the service.

There was complaints folder in place. The provider told us that they had not received any complaints from people or their relatives directly. However, two relatives told us that they had made a complaint, but these had not been documented in the complaints folder and investigated in line with the provider’s complaints policy.

The provider did not have effective processes for people and their families to be involved in their care, people did not always feel listened to. For example, one person told us, “The communication with the office is not good, sometimes they don’t give me the right visit times and don’t tell me.”

The provider made sure that people could access the care, support and treatment they needed when they needed it. We did not identify any concerns or barriers relating to people’s ability to access the service.

The provider told us, they treated everyone with respect and kindness regardless of their race, religion, gender and sexual orientation. Staff spoke positively about working for the service and told us that they felt supported by their colleagues and the registered manager.

The provider and staff told us that they presently did not have to support anyone with cultural needs. However, if they did then they would support people to have their diverse and cultural needs met.

Staff had received equality and diversity training and were able to describe how they respected people equally.

Staff had received training in end-of-life care. Although the provider was not supporting anyone with end-of-life care, records showed, and people confirmed that discussions with people or their relatives had not always taken place in relation to end-of-life care. One person said, “We have not discussed end of life care.” Another person said, “No end-of-life care discussed” and a third person said, “No discussion regarding End-of-Life care.”

We raised this with the manager who told us that they would ensure that they undertook these discussions and update care records.