Bexley Home Care

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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 identified one breach of the legal regulations. People were not always supported in a person-centred way in relation to their health and care needs. Staff were not always aware of people’s health conditions. People’s wishes and preferences were not always respected. The way people communicated was not always clearly documented. People and their relatives were not always involved in reviewing their care.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not always receive the appropriate care and treatment. For example, people and relatives, we spoke with told us that they were not given a choice of male or female staff. One family member told us that at times they had to support their loved one as a female staff member was not always allocated to the care call, they told us, “Something needs to be done about the male carer at the weekend, I think it’s unusual. It’s now at the stage that he is sat in his car whilst I’m doing his job with the other carer [because they are unable to send a female carer]”. The majority of people and their relatives had little awareness of care plans, or regular care reviews. One person said, “I can’t recall seeing a care plan.” A relative told us, “There is a folder in the flat which [staff] fill out.” In relation to care plan reviews, one relative said, “There’s been no review of [person’s] care plan.” Another relative said, “[Office] talk to us when is required. I can’t recall any reviews”. When people/or their relatives were not involved in care reviews, this meant that the provider could not be assured that they had up to date information about people health and care needs, any new risks to people and how to mitigate these safely. Care plans were not reflective of ensuring people received personalised care according to their specific needs. For example, for people with specific conditions such as diabetes and living with dementia, there were generic fact sheets about these conditions. There was no guidance for staff that was specific to the person which showed how the conditions impacted their daily lives, the potential risks involved and the appropriate support they required from staff. For a person who used sign language, there was no information for staff in their care plan which showed how the person communicated and how staff should communicate with them.

We raised the issue in relation to preferences with the gender of care staff and care reviews with the provider. The provider told us they could not accommodate the person’s preferred gender of care staff due to the unavailability of regular staff, especially at weekends and regular care reviews were carried out, however, records showed these were not always documented. Staff we spoke with, did not always know about people’s health conditions and how they affected them. For example, a person was allergic to a specific medicine and staff were not aware of this. One staff member said, “[Person] not allergic to anything.” Another staff member said, “[Person] has no allergies to my knowledge.” Staff also did not know about people’s mental or physical health conditions. One staff member said, “I did not know that [person] has a [mental health condition].” Another staff member said, I don’t know about all of [person’s] physical health conditions.’

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Listening to and involving people during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People and relatives told us they could easily speak to staff or managers. Management operated an open-door policy where people, staff, relatives could contact them if they had any concerns.

The provider told us, they treated everyone with respect and kindness regardless of their race, religion, gender and sexual orientation. Staff told us they received details about their shifts on time. Staff spoke positively about working for the service and told us that they felt supported by their colleagues and management. One staff member said, “Managers are supportive, they have an open-door policy.”

People’s preference to not have a male carer was not always accommodated and respected. There were no records to show that staff had received equality and diversity training. However, staff were able to describe how they respected people equally. The provider and staff told us that although they presently did not have anyone with any cultural needs, if they did then they would be supported to have their diverse needs, including spiritual and cultural needs met. Staff told us there were regular meetings held for staff to share their views and experiences. One staff member said, “I have regular team meetings – all good.”

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.