Collingswood House

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

The key question of responsive was rated for the first time at this assessment and was rated good. Most care and support was person centred and designed around people’s needs, preferences and wishes. However, some people’s care had failed to recognise people’s rights under the MCA and therefore their care was not individualised to them. However, managers and staff often went far beyond what was contractually required of the service. Staff either got to know people on shadowing visits, or in urgent situations by reading the person’s care plan. People were supplied with the information they needed in a format they could use. The service had a good understanding of discrimination and inequality, and they worked hard to be able to support every person that was referred to them. Some people did not always feel supported to raise concerns with the management of the service, but the service managers were working hard to make people feel comfortable to approach them whenever they had concerns. Some of the communication between people and the office had been handled poorly but the service management was taking action to improve this. The investigation of complaints had recently been improved but further improvement work was continuing. The service supported people to plan for the future, so they could make informed decisions in advance of the end of their life. The service provided as much support as they could in the final weeks and days of peoples’ lives.

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 we spoke with about their care said it was person centred and designed around their needs, preferences and wishes. However, some people’s care had failed to recognise their rights under the MCA and therefore their care was not individualised to them.

We heard from managers and staff about many occasions where the management and staff went beyond what was contractually required. For example, they had supported people with their medication including delivering prescriptions to pharmacies and then delivering the medicines to people in their homes. We saw care plans that reflected all parts of the person’s needs and abilities. These were adequately completed in most cases, but did not cover risk and restrictions enough in some cases where the person did not have capacity to consent.

People told us about how the service planned and delivered a service that met their individual and diverse needs. However, we saw the exception was where people did not have capacity and were being restricted into their homes.

The service managers showed us they had a thorough understanding of the needs of the local community and its diversity. They also told us about the diversity of their workforce. They were able to strategically plan for the development of their service to meet the needs of the local community. We also heard examples of people whose individual needs were met effectively by the service.

We did not receive any feedback from partners stating the service did not work closely with Plymouth commissioning for social care services, other Plymouth social care or health care providers.

The service had close relationships with the health and social care system and service managers were confident they could meet all the social care needs of the diverse community in the city.

People and their relatives told us they were supplied with the information they needed in a form that they could use.

We were told by staff, they always attempted to have knowledge of a person who was new to them. They did this either through an initial visit with a colleague, or if at short notice, by reading the person’s care plan on the service’s confidential IT App on their phone.

Everyone had their own paper copy of their care plan in their home. We saw the service could supply information to people in languages other than English and in alternative formats as needed.

Some people told us they did not always feel supported to raise concerns with the management of the service. People and staff also said some of the communication with the service’s office was poor and where a person wanted a response to their enquiry, sometimes they did not hear back. The service had introduced a new approach to phone calls coming into the office, so office staff now took full ownership of these incoming enquiries. The management told us they would work to ensure that people knew of an outcome from any concern they raised. One person said, “Carers, (score)10/10. Office (score) 5, because all too often they don’t respond but I can’t say if this is because they won’t do anything, or that the message doesn’t get through. I think it might be better if the care staff did some training for the office team."

Managers encouraged staff to raise concerns when things went wrong, but staff did not always feel comfortable to do so. The management of the service said they were working hard to ensure staff always felt comfortable to speak to them about any concerns they had.

The provider had processes for staff to report incidents, near misses and safety events. There was a system to record complaints. The complaints investigation and communication approach had been improved within the past few months by the employment of an experienced member of staff specifically to investigate complaints. The managers agreed investigation and communication had previously not been handled as well as it could have been.

None of the people or their relatives we spoke with told us of any discrimination in access to this service.

The management of the service told us about how they ensured access to their services. They had a good understanding of discrimination and inequality, and they worked hard to support everyone individually who was put forward to them to receive a service.

The service managers worked to deliver support that did not discriminate against anyone because of a physical, communication or mental health need. Meetings could take place on the ground floor of the Collingswood House building when physical disability access was needed.

People with capacity and the relatives of people told us people’s individual and diverse needs were met by the service. However, people that did not have capacity and were restricted within their homes did not have their human rights protected.

Staff and service managers told us about how they met peoples’ individual needs.

The service had care assessment and planning processes to meet individual needs. However, these were lacking in cases where people lacked capacity and needed to have these individual needs addressed.

People told us they had Do Not Resuscitate (DNR/TEP) prior directions in place, so their wishes were respected in End of Life situations.

Service managers told us about occasions when they and the staff had gone beyond the care contract, to ensure people were supported at the end of their lives.

The service supported people to plan for the future, so they could make informed decisions in advance of the end of their life. People who were approaching the end of their lives were identified, and together with commissioners, the service provided as much support as they could in the final weeks and days of the person’s life. People’s decisions regarding End of Life support were included within their care plans. Do Not Resuscitate (DNR/ TEP) agreements were held available by the service, so that these could be communicated easily to emergency health services. The service, together with other social care and emergency health services, were beginning to transfer DNR/TEP agreements onto a digital system, so they could always be accessed by all those involved in supporting the person, at all times of the day and night.