Patience Healthcare (Aapna) Ltd

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The service helped people to experience good health and wellbeing outcomes. They did this through understanding people’s needs well and responding proactively to changes. Staff had regard to people’s protected equality characteristics and individualities. Staff with a range of languages, such as Punjab, Hindi and Urdu, provided care. This was a particular strength of the service and people valued this. Consent was factored in to care planning. Feedback from people, relatives and external partners, was consistently positive.

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 spoke positively about how staff helped them on a day-to-day basis and also to support them to understand and attend longer term health appointments. One relative said, “We did have a meeting with a social worker and [Staff member] came to the meeting and supported us completely. They have been fantastic.”

The registered manager worked well with staff, relatives and external partners to ensure people’s needs were understood and met. Staff had the time and opportunity to get to know people and how their needs could be best met. External partners gave positive feedback about how well staff understood people’s needs. They gave examples of where staff had always been able to update them on a person’s changing needs. One said, “Engagement from management and office staff is very good and they are willing to share information and receive constructive feedback.”

Care needs were regularly reviewed from the start of a care package, regularly in the first few weeks, and then less frequently when the person was happy with the care in place. The registered manager was responsive to our feedback about other areas for potential ongoing care planning improvement.

People had confidence in the knowledge and ability of the staff who visited them. They had got to know staff through good levels of continuity, and trusted them with their care needs.

Staff received the training they needed to meet people’s needs. The registered manager was proactive about sourcing training and had members of staff attending ‘train the trainer’ sessions so they could deliver more face to face training. Staff acted on the advice of external clinicians where needed.

The majority of care planning we saw was set out in a logical, task-based format that made it straightforward for staff to understand what was required on each call. Some information about people’s conditions and needs needed to be improved to ensure staff had easier access to them. The registered manager was responsive to this and made improvements to the records we identified during the inspection.

People had no concerns about how staff supported them. They generally knew which staff members would be supporting them and felt staff worked well together.

Feedback from staff was positive. They understood how to access out of hours support and worked well as a team. One member of staff told us. “Management is great, really supportive.” Staff did not raise concerns about the leadership, or how they interacted with other staff. They gave consistently positive feedback about leaders.

External partners gave positive feedback about how staff worked with them, and how they had witnessed staff work together well as a team. One external professional told us, “I felt [deputy manager] and their team were very welcoming of suggestions for different approaches.”

The rota was well planned to ensure people received a continuity of care and staff knew in advance what their responsibilities were. The registered manager worked collaboratively with external partners.

People gave strong examples of how staff took the time to meet their dietary needs. For instance on one occasion the service swapped staff members so the person could be supported by someone who had a better understanding of their national cuisine. One relative said, “The family prepares food and the carer comes and just makes a chapatti or some rice – that suits us very well.” One person said, “Sometimes I help them with my meal because I like to do what I can.”

Staff understood the importance of supporting people’s choices in life. They helped people with food preparation and understood people’s dietary preferences and needs.

Care plans and records did contain a good amount of information about people’s health needs. Care planning and risk assessment information was generally user friendly but would benefit from more rigorous auditing to ensure it was as accurate and accessible as possible.

People told us staff regularly checked if they needed anything else and made sure they were comfortable. They were encouraged to maintain their own health and wellbeing, for instance through good eating and drinking and staying as active as practicable.

Staff were able to access and update care records. They were confident in using the app required to log tasks completed, and they also confirmed there were paper records in people’s houses to help them record information in a format others would find useful. Partners confirmed they could always access the information they needed and that staff helped them enable people to experience better health outcomes. They confirmed that staff provided a level of consistency regarding people’s care.

The provider had successfully rolled out the move to electronic care records. Staff had been supported and trained in using this system and it provided greater accountability in terms of tasks undertaken.

People’s right to choose was fully supported and respected by staff and gave examples of how this happened on a day to day basis. For instance through meal choices, what to wear, and what aspects of personal care they needed help with. One person told us, “I like to do everything I can do myself and so often we will do things together – they support me.”

The registered manager and staff demonstrated a good understanding of assuming people had capacity and being led by their choices. Staff advocated informally for people well and ensured they and family members were signposted in the right direction if they needed more help.

The provider’s MCA policy was up to date and informed by current good practice. Mandatory training included training around consent and capacity.