Care at Home Group Cheshire East and West

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

We assessed 7 quality statements under the responsive key question, identifying both areas of good practice and areas requiring improvement. The overall rating for this key question is good. People received person-centred care that reflected their personal preferences, identity, and wishes, including those related to end-of-life care. Care plans were thoughtfully written to capture these details. Staff had also engaged in recent training to enhance their skills and understanding in this area. However, many individuals reported not having seen their care plan or participated in reviews of their care. Additionally, some found it challenging to communicate with senior staff or leaders regarding their care. Improvements were needed in communication and care plan reviews. These issues had already been identified by the service, and work was underway to address them.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us that care calls were personalised to how they wished to receive their care. This feedback included that they would update staff with any changes.

The manager explained their approach was about putting people at the centre of their care. They gave an example where it had been important to speak with the person directly to gather their views, rather than only following their relative's instructions.

Overall people told us they had good working relationships with staff when receiving care.

The management team had recently responded to a person’s training needs by arranging bespoke training to support staff awareness and competency in that area. One staff member staff. “We just done some recent training for a client's changing care need.”

We received no concerns from partners relating to this quality statement.

Staff worked with partners in health and social care to support a coordinated approach to people's care. Where people’s needs had changed, we saw examples where staff referred to social workers or district nurses for further support. They had developed a process to ensure they could act quickly to start supporting people with care, where they were discharged from hospital.

Overall people told us they had not received a care plan, nor had they been asked for feedback over the care they were receiving. Comments included, “I don't know what's on the care plan as I don't think I've seen it,” “There has been no meeting or discussion about [Person] care since it was first started” and, “I think there is a plan on the phone they [Staff] carry.”

Staff were able to describe how they would adapt their communication styles to meet people’s needs. We were told, “Changing my body language and facial expression is very powerful when trying to identify what someone is trying to communicate.”

Care plans included information about people’s 'circle of care' such as their family or friends. The provider's electronic care planning system enabled the person or their relative, with consent, to access some of these records remotely. However, some people indicated they weren't aware of their care plans or that they had access to these. There was a process whereby people were provided with a service user guide and information about the complaint's procedure at the initial assessment. The provider was able to provide information in alternative formats should this be required.

People said it was sometimes difficult to get hold of people at the office, because phones weren't always answered. They also said they were not always kept informed if calls were going to be late. Most people we spoke with felt they had not been contacted for feedback or to review their care.

Staff told us they would act if people raised feedback or requested changes and report this to the office, who they believed would take appropriate action.

The provider had started to implement quality monitoring calls to review people’s care and gather their feedback about support provided. They had also undertaken surveys to gather general feedback about the service. We saw the latest surveys had been carried out from April to June 2024 and the provider had reviewed the feedback to identify any themes and trends and developed an action plan. Some improvements were needed in relation to communication about calls when they were delayed and people said they had not been visited by the office team. They were in the process of addressing this. Managers told us they had put a new system in place to better respond to phone calls to the office. They said the new recruits to the office team would also enhance the response times.

People told us staff were helpful and supportive to ensure they received the care they wished. We were told, “All the staff who've come have been caring and attentive.”

Overall staff felt they did not have the necessary time to support people in a timely manner, Many discussed concerns over the planning and geophysical coordination of calls, with challenges to complete calls punctually. Comments included, “There are issues with calls, they're expecting you to travel across areas and back for another call” and, “There isn’t enough time.” Another staff member told us, “Little time for staff to be able to be on time for the next appointment.” However, in some instances staff described recent changes and improvements the manager was making. We were told, “Staffing levels are sufficient, and things are well organised.”

The provider had systems in place to support people to access care in urgent situations. For example, when being discharged from hospital they worked with local social and health care teams to support people to access care and respond to changes in their needs. The provider had an on -call service to support staff and people in response to issues or changes outside of office hours.

People told us they felt listened to by staff and their individual needs were taken into account. However, people said issues raised to the office or management team were not always addressed. We were told, “I do phone them if I have any concerns although I sometimes feel that things don't really change.”

Staff described how people’s views were sought during calls with people. This included demonstrating understanding of the importance of promoting and ensuring people’s human rights were protected.

Care plans in place considered people’s personal identity to ensure they were able to receive the support and care they needed. Care plans considered for example, whether people’s sexual orientation, religious or cultural needs impacted on their care needs

Overall people gave mixed feedback over contact from the office and opportunities to discuss and review their care. Comments included, “I've never had a call from the office to see how I am or about anything else” and, “I don't know who the manager is however whenever I've spoken to them in the office, they do seem to be able to rapidly pull up the relevant records and know what they're talking about.” However, we were also told, “It can take a while to get through, if I had any problems, I would talk to [Staff member] at the office.”

The manager shared an example where they had worked with the local end of life care team to support a person to stay at home and have the support they needed.

Assessments and care plans considered people’s end of life needs and wishes. Where people had a 'do not attempt cardio-pulmonary resuscitation order' (DNACPR) in place this was recorded. The provider had arranged training for staff to support them when providing end of life care.