First Choice Home Care (Norwich)

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question as good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect. People told us that generally care staff were kind, respectful and treated them with compassion. However, they felt the management team were not as approachable or supportive. Several people said it was hard to get in touch with the office when they had concerns. Where they had raised concerns, people told us they did not always hear back in a timely way. We found evidence that call times were often delayed or changed without being communicated to people, and people told us this made it difficult for them to make plans or feel in control of their day.

This service scored 45 (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 treated with kindness, empathy and compassion. We received mixed feedback from relatives and people using the service. Most people felt care staff were kind and compassionate. However, several people and their families reported experiences which made them feel unsupported or dismissed by management and office staff in response to concerns or queries they had raised. One person said ‘I can’t fault the carers at all, but the management side I am not sure about’. Most people we spoke with had needed to raise a concern or complaint at some point whilst receiving care from the service. However, people and their relatives did not feel these had been handled in a kind and caring way. A relative told us ‘They never come back with anything. They hope [my feedback] just goes away'.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing. We found limited evidence that people had been involved in discussions about the care they received, and whether they were happy with it. We received mixed feedback about how the service was ensuring people had independence, choice and control over their care. Where people wanted to make plans, they told us their daily life was impacted due to changes with call times which they were not informed about. One person told us, “I use an app which tells me the times, but it changes so many times I cannot plan my day.”Another person told us how they had not been informed their visit was going to be late, and when the carer arrived, it was during a scheduled appointment with a healthcare professional. This meant they missed their hot meal. Whilst people were understanding of unexpected delays, they found the communication regarding visit times changing to be poor.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing. We found limited evidence that people had been involved in discussions about the care they received, and whether they were happy with it. We received mixed feedback about how the service was ensuring people had independence, choice and control over their care. Where people wanted to make plans, they told us their daily life was impacted due to changes with call times which they were not informed about. One person told us, “I use an app which tells me the times, but it changes so many times I cannot plan my day.”Another person told us how they had not been informed their visit was going to be late, and when the carer arrived, it was during a scheduled appointment with a healthcare professional. This meant they missed their hot meal. Whilst people were understanding of unexpected delays, they found the communication regarding visit times changing to be poor.

The provider did not always listen to and understand people’s needs, views and wishes. Where people or their relatives needed to speak with management or office-based staff, they told us this was difficult. A family member told us, “When you call, you can leave a message, and they say they can’t pick up messages from that phone – so what is the point? It's really hard to get through. Calling them is very frustrating.” However, people told us they found most care staff to be helpful and responsive to their needs. One person’s relative said, “They always ask if [my relative] is okay and ask if they need anything.” We saw from Electronic Call Monitoring data that staff were often not staying for the full length of the call, and a quarter of total calls delivered were less than half of their planned duration. People and staff told us this was because staff were given insufficient travel time. The provider was unaware of the amount of calls being cut short, and did not demonstrate they had proactive systems in place to investigate the reason for this happening so frequently. Where incidents had occurred, records did not reflect that action had been taken in a timely way to ensure peoples care continued to meet their needs.

The provider did not always care about and promote the wellbeing of their staff. We found that staff did not always receive sufficient supervision or support from the service. Most staff we spoke with did not feel respected or supported. Feedback we received from people using the service also reflected concern regarding the treatment of care staff. Some staff spoke positively about the relationships they had with their peers and said they had developed a support network amongst themselves which they valued. However, we received a high rate of negative feedback about the support staff received from senior management teams. One staff member told us, “They just want us to work and just burn us out.”