Sambhana Care Ltd

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 provider met people’s needs. At our last assessment this key question was not assessed. At this assessment the rating is inadequate. This meant services were not planned or delivered in ways that met people’s needs. The service was in breach of a legal regulation in relation to duty of candour.

This service scored 32 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs. There were no effective systems in place to make sure people and their relatives were involved in developing their care plans. People and relatives told us they had not been involved with developing their care plan. Care plans were not person centred, most of the guidance had been generated by the electronic care plan system and did not relate to the person. The provider and senior staff did not always know what support was being provided by staff. They described people’s support, but this was not accurate and did not reflect the information contained within care plans. The senior staff would not have the knowledge to check the staff were providing the support required.

There were significant shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not joined-up, flexible or supportive of choice and continuity. Some people received support from private care staff or other care agencies, this was not clearly documented in people’s care plans. There was no information or guidance about which areas of support each were responsible for and no co-ordinated way of working to ensure people’s care needs were fully met. For example, in the preparation of food, it was unclear if the private night staff or Sambhana Care Ltd staff would prepare a person’s breakfast. When this was discussed with senior staff, they did not know who provided the breakfast and had not checked if the person was receiving their breakfast. This placed people at risk of not receiving the support they needed.

The provider did not supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The provider did not provide accurate and up to date information to people or their relatives. There were no processes in place to make sure people received information in the way they preferred. People’s communication needs had not been assessed and there was no information in the care plan about these specific needs. Essential information such as the complaints procedure had not been provided in an accessible format. The provider had not provided relatives with accurate information about people’s health and care needs or informed them when things had gone wrong.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. The provider told us there was a copy of the complaints process given to each person or relative when they started using the service. Relatives told us they knew how to complain. They had raised concerns with the management team, these had been responded to quickly and resolved. There was a complaint log maintained which showed complaints had been dealt with. However, relatives had not always had accurate information given to them by the provider when incidents had happened, the provider had given relatives information in a way which reflected positively on the service. People and relatives had not always been given the opportunity to give feedback through quality assurance surveys. Relatives told us they had not received any requests for feedback about the care their loved ones received.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Staff supported people to access vaccinations and other healthcare professionals, but this was only done when people requested this support. Care plans did not contain information for staff about how to recognise when people were unwell and when to refer people to health professionals. There was a risk staff would not refer people as required, to health professionals, especially if people did not have someone to advocate on their behalf.

Staff and leaders did not listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not tailored in response to this. The service supported people from different ethnic backgrounds with many coming from a Punjabi background. This was not recognised in people’s care plans, there was very little reference to how their religious or communication needs might affect their care and treatment. For example, 1 person had remarked on their survey, that not all staff knew how to make a turban, which the person needed assistance with. There were no processes in place to evaluate the outcomes of people’s care and how improvements could be made.

People were not 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’s care plans did not always contain future plans, particularly end of life care. Where people were receiving palliative care, their care plans these were not personalised. They had been completed with generic outcomes from the electronic planning system. The plans did not contain details about people’s choices and preferences especially around their religious or spiritual needs.