Caring Connections - Warrington

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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 did not always receive person centred care which met their needs. People and their relatives were not always involved in the care planning process. Where people had specific activities they wished to undertake, staff did not always support them to achieve this. People felt some staff did not always understand their individual needs and choices, and staff had a limited understanding of how to provide responsive, person centred care. There were several policies in place regarding equality and diversity to guide staff on how they should support people in a responsive way.

This service scored 14 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they were not always involved in their care planning, or they had not seen a care plan. One person said, "I never had a meeting, they [carers] just turned up." Some people did not think the staff always understood their needs. One person said, "I don't think they [staff] realise an old person can't do what a young person can." However, some people spoke positively of staff providing person centred care. A person told us, "They [staff] absolutely do understand me. I treat them with respect and get it back."

Not all staff had seen people's care plans prior to commencing support. They were not aware of people's needs and relied on the work based phone app to tell what support was required. The care plans had limited information on how to meet people's individual needs, and did not guide staff on how to support people to ensure their needs were fully met. The management team did not have sufficient oversight of people's care plans. We were initially told the care plans were kept in people's homes. However, on further discussion it transpired they were electronic. People did not always receive their full commissioned support call in terms of duration. As a result, people's care and support was often rushed. One staff member told us, "There are problems when people are ringing in sick, so sometimes calls can change as you have to squeeze people's care in." Some staff understood the importance of providing person-centred care. They said, "[Person] finds it difficult to understand sometimes so when the occupational therapist comes out we incorporate what they say" and, "I would always listen to people and see what they need and we will see what we can do. If someone has dementia, I would show them clothes and give people a choice. I always ask them what they want and the choices are there."

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.

Some people did not always feel empowered to achieve outcomes which were meaningful to them. One person who was commissioned for community access, was not always able to undertake this due to staffing difficulties. Another person who was visually impaired did not always know who was providing their support. One person said, “Sometimes I don't think they [staff] understand being disabled means you can't do things.”

Staff told us they treated the people they supported in the same way. No members of staff were aware of any occasions where people had been treated differently. However, at times staff were unsure of how to provide care in line with consent and people's outcomes. One staff member said, “If a person doesn’t have capacity, I wouldn’t ask them whether they wanted a body wash as it's on the task list. I would tell them what I'm doing, but I don’t ask, otherwise they may say no.”

There were several policies in place outlining how staff should support people with equality in outcomes, and how to identify inequalities in people's care . This included anti slavery, human trafficking and fair access, diversity and inclusion policies. The provider ensured equal opportunities forms were used in recruitment practices to provide equal outcomes for new staff. The provider had worked to achieve the "Navajo" chartermark award, in recognition of progress and commitment towards involving LGBTIQQA people. The award signifies good practice, commitment and knowledge of the specific needs, issues and barriers for LGBTIQQA people.

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.