Right at Home Chippenham

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• 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 reviewed 7 quality statements in this key question.

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 were receiving person-centred care. Where appropriate, and people had consented, their relatives were also involved in their care assessments. If relatives wanted access to the electronic care plans system, this could be arranged.

Staff shared examples of the type of person-centred care they provided day to day. In addition, the registered manager shared some case studies with us of personalised care they had provided people in the past.

Overall people had a continuity in their care and support as they were visited by the same group of staff. One person told us, “I have had excellent care since starting the service. I usually see the same faces, but it depends on who is available.” Some people and relatives did share they found staff could be late at times and they were not always informed. People had shared this feedback in a recent quality survey and the registered manager told us they were working to resolve any concerns.

Staff told us they thought they were providing a good continuity for people as they were visiting the same people on a regular basis. Staff told us this enabled them to learn about people’s individual needs and get to know them well. The registered manager told us they always tried to be flexible and increase or decrease care when needed. They told us they had often liaised with the local authority to agree funding for increased care packages at short notice.

Professionals we contacted did not share any concerns about this quality statement.

People had hospital passports to share with emergency staff if needed. The providers electronic care planning system allowed office staff to assign visits to specific care staff. This made sure people had the same workers if that had been agreed with them.

People were able to have information in a variety of ways to meet their individual needs.

The registered manager was aware of the need to identify people’s individual communication needs and preferences. They shared with us some examples of work they had completed to provide people with information in a personalised way. For example, staff had used picture cards to help communicate with 1 person with dementia. For another person, staff had used information in a different language to help communicate with 1 person. The registered manager told us they tried to match care staff with people if they shared cultures and languages.

Since 2016 all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (AIS). The AIS tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their carers, get information in a way they can understand it. it also says that people should get the support they need in relation to communication. We found the provider was following the AIS making sure people’s communication needs were recorded. Staff knew people’s communication needs and how to support people with any information sharing.

People and relatives were aware of the complaints policy. People told us if they had complained about anything action had been taken. One person told us, “If I tell them something they seem to listen and do it every time. If I have complained in the past, something has always been done.”

The registered manager told us they recorded all complaints received and tried to resolve them within the providers timeframe for resolving complaints.

The provider had a complaints policy which outlined steps for people to take if they wanted to raise a complaint. Complaints were reviewed and analysed to identify any trends or themes. People were asked for their views about their care and any improvements that could be made. A summary of responses letter had been sent out to people including what improvements the service was going to make.

People were able to have support from staff if needed to access various services. For example, some people were not able to use electronic medicines ordering systems, or it was difficult for them to telephone GP surgeries. Staff provided people with support to order and collect medicines to make sure they always had supplies.

The registered manager told us there were processes and step by step guides for staff to make sure people had opportunities to access their local community and services. Staff often acted as advocates for people to make sure they had the care they needed in a timely way.

Professionals we contacted did not share any concerns about this quality statement.

The provider had office staff available to people, relatives and care staff when needed. Out of office hours there was an on-call system which anyone could ring for advice, guidance and support. This service was also available at weekends. Information was provided to people in a service user guide for them to know where to go for help and guidance.

People did not share any concerns about this quality statement.

Staff shared examples of how they supported people to access their local community and services. Staff were aware of how some groups of people could experience discrimination and what they could do to overcome this. For example, staff told us about support they provided for a person with dementia. The person had not been able to leave their home due to safety concerns. Staff enabled the person to regularly go for a walk and visit a local coffee shop which the person enjoyed. Staff told us they recognised the importance of people maintaining their routines.

Staff received training on human rights legislation and the importance of the Mental Capacity Act 2005 (MCA). The registered manager told us they talked with staff on the importance of people being supported to make their own decision and live their own lives. Staff also worked with family members to raise awareness of discrimination and human rights.

People recorded their wishes for end-of-life care and any future planning needs. Where people had taken this opportunity to record their wishes in their care plans, staff had access and were aware of their needs.

Staff were comfortable providing people with end-of-life care and told us they had provided this type of care in the past. Staff told us they had been provided with training, but some staff wanted more training on this area of care. One member of staff told us, “I have done end of life care. We have touched on this during a course, and I have put myself forward to do more training on this as I would like to know more. It is quite rewarding to know you have done your best for the person wanting to stay at home at this time.” Another member of staff said, “I feel comfortable asking questions about end-of-life care. We did training online with national office about managing difficult conversations, which helped us by giving us words to say. That was really nice I enjoyed the training, and it really helped me think about having those difficult conversations with people at a really difficult time, both for them and the family.”

People who were receiving palliative care had their wishes and needs recorded for staff to follow. At the time of our assessment there was no end-of-life care being provided. People who had been assessed as needing palliative care had their wishes recorded. Staff had worked with the persons GP to make sure people had reviews of all medicines.