Personalized Care Services

There was a positive learning culture in the service, and collaborative working with relevant agencies to manage risks, support with health needs and safeguarding concerns. People’s environments were assessed to ensure the safety of people and staff. There were robust recruitment processes in place, and staff received relevant training to fulfil their role. Appropriate infection, prevention and control, (IPC) policies were in place, however, some people using the service expressed concern regarding IPC procedures. Improvements were needed to medicine management, particularly relating to ‘as and when required’ (PRN) protocols, to ensure correct strength of medications were documented and clear directions were in place. The service responded by making changes to PRN protocols after the inspection feedback.

People told us their needs were well assessed. The service worked well with local agencies such as the local authority, to determine an assessment of need. Care plans, at times, lacked important detailed information about people’s health and how the service could demonstrate its ability to deliver evidence-based care. Staff worked well across teams to support both assessment of, and delivery of care. Professionals and staff provided positive feedback regarding multi agency working with the service. People were supported to live healthier lives by accessing local community services. Some improvements were needed regarding the monitoring and improving of people’s outcomes. For example, it was not always clear what actions had been taken to support liaison with relevant professionals around moving and handling. There was consent documentation in place, however, this did not incorporate relevant legislation such as Mental Capacity Act 2005, (MCA, 2005). However, people told us they had discussions with staff regarding consent during their care. The service advised us how they will make improvements in this area.

Most people spoke highly of staff and advised they went “Above and beyond.” This was also echoed by professionals who worked with the service. People’s care plans required further detailed information, for example, regarding dietary information, to ensure care plans were tailored to individuals. People were supported to promote their independence, choice and control as far as possible. People received care calls in a timely manner. Staff felt well supported with their wellbeing. The service has told us how they will make improvements to the level of detail in people’s care plans.

Care plans had a lack of important information to respond to any changes in need. For example, if someone displayed a deterioration in mental health. The service understood the diverse needs of its community and worked well with relevant agencies. Information provided to people lacked relevant detail, for example, a legislative framework to the service, or contact details regarding safeguarding concerns. People who may be at risk of inequality were well supported to have equal access, experiences and outcomes. For example, people were provided with easy read information about their care. People and staff were involved in discussions around care, although people were not always supported to discuss important life decisions, including end of life. The service has told us how it will make improvements in this area. There was a shared culture and approach within the service, demonstrated by leaders, and embedded with staff during team meetings and supervisions. The service had capable, compassionate leaders, and auditing processes were well embedded. Staff, professionals and people using the service provided positive feedback regarding leaders and felt able to raise any concerns. Recruitment processes showed a diverse workforce, based on a staff equality and diversity policy. There were well established and robust systems in place to support good governance. The service worked well in partnership with relevant partners and communities to support people. Staff were well supported with their learning and career progress and told us they were supported to give ideas regarding any improvements in the service.

The service was responsive to any recommendations made and had already made changes to documentation based on findings in the assessment. The service received largely positive feedback from people, staff and professionals, particularly in relation to positive leadership within the service.