Care & Grace

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

People reported their care was person-centred and the majority of staff knew them well. However, people’s care records did not reflect important information they shared with us about their individual needs and risks, which placed people at risk of receiving inconsistent, ineffective or unsafe care. People’s care records lacked detail and failed to reflect their physical, mental, emotional and social needs. Staff had not been provided with information regarding the risks to people and how to mitigate those risks and care records lacked information regarding people’s healthcare needs. Information was made available to people in a format that was accessible to them. People, relatives and advocates all felt listened to and reported the provider responded to any concerns they may have promptly and effectively, but there were no records available to demonstrate this. People were supported to access care services to help them maintain good health. The service did not currently support people who required end of life care, but the provider was confident that arrangements could be made to support people if required.

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, their relatives and advocates told us care staff knew them well and they had been involved in the planning of their care. A relative told us, “To be honest, there is nothing they [care staff] don’t know about [person] – they are like my family and know what is happening day to day.” However, 1 relative told us that although the majority of staff knew their loved one well, there had been an occasion when a member of staff had arrived and did not know what they needed to do to support the person. People, their loved ones and advocates told us if they needed to discuss any changes in their care, they would speak to the provider and the changes were introduced immediately. For example, a relative advised their loved one was prescribed some additional medication and arrangements were put in place to collect this and actions taken to ensure it was administered correctly.

Staff were able to explain how they supported people, but the information and knowledge they shared with us was not always reflected in people’s care plans. This meant people were at risk of receiving inconsistent levels of care and treatment. Staff were not aware of the particular details of people’s healthcare conditions and the potential impact of these conditions on their daily lives. Staff were not aware of this additional information which would guide them to manage this condition and mitigate the risks associated with it. Further, people’s care records had not been reviewed and held incorrect or out of date information. For example, one person’s file directed staff to empty their ‘leg bag’ but the provider confirmed the person did not have a catheter in place. The provider was unable to demonstrate to us that formal reviews of people’s care were taking place which would provide staff with up-to date information on how to meet people’s particular care needs.

People, relatives and advocates told us staff worked alongside other health and care professionals to meet their needs. A relative described how flexible the service was in order to respond to the increasing needs of their loved one and the positive impact this had on them.

Staff were aware of some of the health care professionals people were supported by and talked of the positive relationship they had with them, including district nurses and GPs.

A healthcare professional reported the service responded quickly to the changing needs of a person they supported. They told us, “[Provider’s name] is brilliant, keeps me informed and is very open and transparent. They have been really helpful if gathering information I need; they are very knowledgeable.”

Despite staff describing occasions when they had spoken with other healthcare professionals regarding people’s needs, there was no record of these conversations, any agreed actions or exchanges in information held in people’s care records.

People told us they were able to access information that was in a format that was accessible to them. A relative described how staff took the time to speak with their loved one, lowering their tone and speaking softly, ensuring they understood what was being said to them.

People’s care records held information about their communication needs and staff spoken with were aware of these needs.

The provider was aware of the need to provide people with information in alternative formats, for example large print/first language, if required. Large print documentation had been provided for 1 person using the service.

People and relatives told us they felt listened to by the provider and provided several examples where they had contacted them with concerns and had been listened and responded to immediately. One person told us, “There have been some issues with some staff but [provider’s name] sorts it all; she is wonderful.”

Staff reported that any concerns that were raised were directed to the provider to be looked into. Despite people, relatives and advocates telling us the provider had responded to a number of complaints and concerns, there was no documented evidence of these particular incidents. The provider confirmed this was the case and that these issues had been dealt with informally.

People, relatives and advocates told us if they had any concerns or raised a complaint, it was always dealt with promptly and to their satisfaction. However, as there was no documented evidence of these particular issues being looked into, opportunities to analyse the findings of these investigations for any trends or lessons learnt, were lost. We saw evidence of a response to a complaint that had very recently been received during the assessment, regarding standards of care. An apology was sent to the complainant, providing assurances of actions taken. However, there was no documented evidence of an investigation into the concerns raised.

People, relatives and advocates told us they were supported to access care, support and treatment when required.

Staff confirmed they supported people to access medical appointments where appropriate and were alert to the potential inequalities that could disadvantage different groups of people who were accessing care, treatment and support.

A social worker confirmed the service supported people to access services and worked alongside them to source appropriate care and treatment for people by sharing information.

The provider ensured staff were available to support people to attend medical appointments. People told us they were involved in the planning of their care but there was little documented evidence to support this. They told us they were in regular contact with the provider and any changes in care needs were shared during these conversations, but there were no formal arrangements in place for reviews of care.

People, relatives and advocates told us they were supported to access care, support and treatment when required. They told us they felt their views were listened to and acted on. Everyone spoken with had great faith in the provider and reported that they could raise any concerns and they would be dealt with in a timely manner.

Staff supported people to attend any medical appointments where appropriate. Staff were aware of the of the discrimination and inequality that could disadvantage different groups of people in accessing care, treatment and support. They knew when to raise any concerns regarding these issues with the provider.

The inspection team did not review processes under this quality statement. Therefore, this has been given a score of 3.

At the time of the assessment, people had not been asked about their end of life preferences in their care plans and there was no one currently supported by the service who required end of life care and support. People, relatives and advocates all reported they would speak to the provider if they wished to discuss these issues.

Staff were not aware of people’s end of life preferences as this information had not been gathered. However, they were confident that if people required this additional support, the provider would arrange for these conversations to take place and the information would be shared with them.

The provider advised these conversations with people regarding their end of life preferences would take place where appropriate.