First Choice Home Care (Norwich)

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 as requires improvement. This meant people’s needs were not always met. People were at risk of not receiving appropriate support due to the lack of an effective care planning system. Not all care plans contained sufficient information to guide staff to be able to meet people’s needs. Where people were living with complex physical or mental health conditions, there was a lack of individualised information relating to these conditions. We saw people were supported by large teams of staff, and without thorough guidance in place, this increased the risk of people receiving a poor standard of care.

This service scored 50 (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 place sufficient emphasis on understanding and meeting peoples individual care and support needs. Care was not consistently reviewed or adapted to reflect changes in people’s health or support needs. Care plans were of poor quality and were largely task orientated with a lack of meaningful detail. In some cases, generic information had been copied from the internet into care plans, including complex medical content that would be difficult for non-clinical staff to understand. This had been done in response to our inspection visit. This approach to record-keeping failed to demonstrate that staff had a clear guidance relating to each person’s specific needs, preferences and health requirements.

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. There was a lack of continuity in care, with people being supported by large teams of staff. One person told us ‘I have 17 carers, I do not like it, it is very difficult, but I am used to it’. People and their relatives told us internal communication within the service was poor. However, they said the service communicated effectively with external agencies, including GP’s and other healthcare professionals. People also reported inconsistency in call times, stating that carers were often late, and they were not informed of delays. We found evidence in support of peoples feedback and were not assured people received care which consistently valued continuity and integration.

Information was not always provided in a way which people could access it with easily. The service used electronic care plan software, however not everyone had access to their most up to date care records. Whilst some people were able to access the application used by the service, others were waiting extended periods of time.

The individual communication needs of people using the service were not always thoroughly assessed. This included for people living with a learning disability who required staff to adapt they way they communicated with them.

Healthcare professionals, people using the service and their relatives told us the service was difficult to speak with. Where some people had needed to complain, they felt they did not receive feedback or information in a timely way in response.

The provider did not always make it easy for people to share feedback and ideas, or to raise complaints about the care they received. Whilst the provider undertook satisfaction surveys, these had a very low response rate, and did not contain sufficient information to make an accurate assessment of peoples experience overall. One person told us ‘I feedback through [care staff] but am not encouraged to feedback’. Another person told us ‘One upon a time they did carer of the month so I could feedback and carers would be praised for their work, I do not know if this is still happening’.

The provider did not always seek information from people who are most likely to experience inequality in experience or outcomes. This meant peoples care was not always tailored in response to their individual circumstances.

People’s voices were not always listened to, and people told us they were not always involved in the review of the care they received. Where people had raised concerns, action was not always taken to improve their experience. People receiving care from the service shared examples with us which supported our judgement.

Staff had received training in equality, diversity and human rights.

The provider did not always seek information from people who are most likely to experience inequality in experience or outcomes. This meant peoples care was not always tailored in response to their individual circumstances.

People’s voices were not always listened to, and people told us they were not always involved in the review of the care they received. Where people had raised concerns, action was not always taken to improve their experience. People receiving care from the service shared examples with us which supported our judgement.

Staff had received training in equality, diversity and human rights.

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.

Staff and leaders liaised with relevant healthcare professionals when people’s health deteriorated, however there was not always a reliable process in place to support these conversations before people became unwell.

Where people were living with a learning disability or mental health condition, we saw some evidence of goal setting to support independence. However, the progress people were making towards their goals and wishes was not analysed or monitored to support positive outcomes for people.