A1 Quality Homecare Limited Eastbourne

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

Care provided was person-centred. People were involved in shaping their care and told us that they were supported how they wanted to be. The service worked well with external professionals to ensure good care provision and access to additional services such as the GP. People’s communication needs were detailed in their care plans and any specific needs were supported. There was a robust complaints procedure in place and people spoke of confidence in raising any concerns with the office or registered manager.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s care was person-centred. People told us that they were involved in their care and treatment, supported to make choices and staff knew them well. A person said, “We get the same two [staff], five days per week. Then we get a regular and one other at weekends. They get to know us”. Another told us, “Yes, I’m able to talk openly with them about the care I need.” Relatives were also confident that care was provided in a person-centred way. One told us, “They sat with mum and I and asked lots of questions, they got to know how mum likes things.”

Staff understood person centred care and put people first in all decisions and tasks they were involved with. A member of staff said, “Last night I was introduced to a new client. I smile, it’s an exciting moment. I go through the support plan and risks and see how I can help the person.” Staff told us how they make sure they deliver the package of care that people need and that it is tailored to their specific needs. Staff adapted care call times to suit people’s routines and personal preferences. Staff told us they had time to read care plans before starting to support someone and had opportunities to read updates and the latest care notes each time they visited. Care plans were person centred.

People’s care needs were regularly reviewed, and staff understood the diversity of these needs. Care plans were adapted where needed to ensure people’s needs were met. A person told us, “They are fairly flexible and as far as I can say no changes are required. But for example, if we need to change a time or have them longer, they will always accommodate that and are very helpful”.

Staff knew people well and were aware of when additional support was needed. Staff worked well with other professionals to make sure that people had access to the services they needed. For example, district nurses were contacted in the vent of concerns around skin damage. Staff worked well with occupational therapists when there were concerns around moving and handling and there were positive relationships with pharmacists when people needed new supplies of medicines. In most cases people were also supported by their families.

Staff worked closely with other professionals and agencies to ensure a joined-up approach to people’s care. Professionals spoke highly of the level of communication they received from staff which promoted good continuation of care for people. One professional told us, “There is plenty of detail in handovers. Staff are able to support clients wholly as they have very detailed support plans in place.”

Within care plans and specifically risk assessments there is a paragraph relating to actions to be taken for example, following a fall. Always consider calling 999 / 111, GP and relatives. Contact details sheets contain key professional contacts including GP, social worker, occupational therapist. Further key contact with interest in clients are the fee payers, in most cases this is the local authority. The local authority carry out their own periodic reviews of care provision and liaise with the service if there are any changes needed.

People were involved in the shaping of their care plans, and relatives were consulted where appropriate. Any communication needs were documented in people’s care plans. A relative told us, “They update me regularly. I was involved with [person’s] care plan, and it is followed correctly. They have kept the number of carers consistent.” A person explained that communication had improved since the service relocated their office.

Staff knew people well and knew how best to communicate with people. A staff member told us about how they communicate with non-verbal clients. They explained that they understood their facial expressions to indicate whether they were happy, needed anything or were simply indicating yes or no. Staff told us about people they supported who had hearing difficulties. Different methods were used for different people. For example, sometime simply speaking clearly and slowly to allow people to lip read and in other cases to write things down on a pad of paper. The registered manager told us that the service had communication aids for example, flash cards and they had been use din the past but were not currently needed. The registered manager was aware of accessible information standards (AIS). AIS provides the legal framework to support people with their communication needs.

Care plans had a section about communication. These highlighted any issues people had and the approaches that staff and other professionals should take when talking to and supporting them. The plans stressed the importance of introductions, making sure people knew who they were and positioning themselves where they could be seen.

People told us they felt listened to and had no issues with contacting the office should a problem occur. A person told us, “I have filled in 2 feedback forms since I began having them. If I do have any problems, for example one didn’t wear gloves, then I just ring the office about it. They are easy to communicate with. They sorted it out straight away.” A relative added, “They always respond, and it will be noted or someone will come out. A lady did a full written report in the file. It’s always dealt with, it’s never ignored.”

There was a complaints policy in place and the registered manager maintained oversight of all complaints that were made about the service. Staff told us that if they received a complaint for a person or their relatives that they would report it and speak to their line managers. Staff told us they had positive relationships with the family members and loved ones of people they supported.

A copy of the complaints policy was kept in people’s homes. People were encouraged to raise issues and concerns. This could be done at any time during a care call or through completing surveys. We looked at some of the issues and concerns raised and saw that managers followed up in a timely way in line with service policy.

People were supported to access additional services if needed. For example, people told us they had been supported to contact a GP. Some care calls were organised to coincide with district nurse visits to make access to the property easier, and help the person feel more at ease.

The registered manager told us that the service supported people in accessing the services they needed. Although most appointments and referrals were made by family members, staff were always available to support when needed. A staff member told us that some people were escorted to a local resource where they could have a full bath as they did not have facilities at their home.

Professionals spoke positively regarding staff promoting people’s access to services. Feedback confirmed that appropriate action had been taken by staff to ensure people could access any additional support they required. One professional told us, “Impression so far is that the communication is positive, they participate in reviews and are strong advocates for the clients.”

The registered manager explained that the service made sure people had access to all of the services they needed to support their health and wellbeing. These issues were mainly covered by family members but staff were always available to step in to support with making and facilitating appointments when needed. Care call times were adjusted when needed to support this.

People were supported with the individual needs. Protected characteristics were documented and any needs around these were embedded into people’s care plans. Staff had undertaken specific training in equality and diversity and a person told us that it was evident that staff knew how to promote equity.

Staff told us they ensure people all receive the same levels of support and access to other professionals when needed. Day to day contact with other professionals was positive. Occasionally some groups were hard to get hold of but these issues were well known and more time was allocated to these services responding to minimise any adverse effect on people. Staff and managers told us how people with different cultural backgrounds were matched, when appropriate, with carers from similar backgrounds. This had led to positive feedback from people and their families.

There was evidence in care plans of client involvement in every stage of the process. This included pre-assessment, reviews of support plans and risk assessments. Care plans stipulated explaining to people what the actual risks are and how the staff team plan on minimising the risks. Family / advocate involvement was important and referred to where appropriate.

The service was not supporting anyone at the end of their lives at the time of assessment. However, people and their relatives were able to discuss future plans, and these were documented. For example, one relative told us that their loved one is likely to need more care soon and they were confident that the service could provide this and flex to adapt to their increasing needs.

Staff had been trained in end of life care and were able to tell us about the important aspects of support for people at this time of their lives. Comments from staff included, “Have had training. Make things nice for them. Involve the family and do your best. Report everything back,” “Had training, yes. Make people as comfortable as they can be. It’s a special time, they are fragile and need support” and “They feel pain more so important to try and minimise pain. Be polite and caring and make peaceful. Change the subject with them when talking. Be careful during personal care. Talk to them and make comfortable.” The registered manager told us that they will always follow family wishes with end of life care and this sometimes meant supporting people at home until the end rather than transfer them to a hospice.

Care plans made reference to DNACPR forms and in most cases these had been completed and were attached to paperwork in people’s homes. Similarly, Respect forms were included in care plans, containing information relating to future emergency care if needed. People living without full mental capacity to make certain decisions had been supported through best interest meetings to plan for the future, to make decisions about future care and support for a time when they were less likely to be able to make the decisions independently.