Health & Alliance Home Care

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 service met people’s needs. This is the first assessment for this service. This key question has been rated requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes their needs. Despite the provider meeting with people, gaining an understanding of their needs, wishes and views this did not result in comprehensive assessments of care. For example, where people had a known medical condition, this was not recorded in a plan of care directing staff on how to effectively support them. When someone was identified at a potential risk of harm there was little to instruct staff on how to safely support them. When people were living with known medical conditions, such as dementia, or required specific support with medical equipment, such as catheters, this was not planned or recorded to ensure consistent care was provided. Despite our findings people and relatives were very positive about the support they received and confirmed the staff met their needs well. One relative said, “Staff are very aware of [relative’s name] likes and dislikes and are very responsive to their changing needs.” The lack of documentation was discussed with the management team and by the time the assessment concluded they had adapted their systems to better account for people’s needs reducing the risk of inconsistencies in the care provided.

There were some shortfalls in how the service understood the diverse health and care needs of people and their local communities, so care was not always joined up, or continuous. Where there were identified changes in people’s well-being these were not always communicated with other health care professionals. For example, where there was a change in a person’s mental health this had not been passed to a partner healthcare provider. However, the provider did encourage people to take positive action themselves to maintain their own independence and act to refer themselves for additional support if needed. In one instance the provider had failed to complete an assessment as directed by a healthcare partner. However, once identified the management team ensured this was completed as directed.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People and relatives told us they received information in a way they could access and understand. One relative said they received regular e-mails and texts. People had care plans in their own homes which they could read when they wanted. People had options of larger print information if they needed, or staff would sit and read through anything to help their understanding. If people required additional equipment, for example glasses or a hearing aid, this was recorded so staff could assist them in accessing relevant information.

The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. People and relatives knew how to raise concerns or to pass on compliments. Two people told us in the past they had to raise issues with the management team. This was quickly resolved to their satisfaction, and they received an outcome to their concerns in a timely way. Everyone had information available to them in a way they could understand to raise concerns. Everyone was positive they would be listened to and responded to appropriately. One person said, “I have never had to complain. If I needed to, I would go to the office or to any member of staff. They are all very efficient. Communication is by e-mail and phone, and we can have good open discussions.”

The service made sure that people could access the care, support and treatment they needed when they needed it. People were supported in their own homes and encouraged by the provider to maintain their own independence. People remained responsible for referring themselves onto additional services. However, if it was needed staff assisted. This included providing information for healthcare services and providing out of hours services and emergency contacts. All those we spoke with confirmed contact details were provided and they felt confident of a positive and timely response if they needed to access out of hours services.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Everyone we spoke with believed they were free from discrimination or inequalities in the care they received from the provider. Staff knew about potential discrimination and if they had concerns, they would encourage the person to act and pass these to the management team to support the person as they wished. The provider had policies and procedures in place, including an equality and diversity policy. Staff were aware of these policies, had received training, and knew what to do if they suspected inequality or discrimination.

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. People and relatives consistently told us those supporting them knew them well and how best to support them. However, there were inconsistencies in the recording of people’s future wishes. Some people had their wishes recorded in a ReSPECT document. This is a document of personalised decisions on clinical care and treatment in a future emergency, should they be unable to make or express choices. However, this was inconsistent and not all those receiving support had such future wishes recorded.