Revelation Social 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

Person centred care plans, reflecting people’s social, emotional and physical needs, were in place. Plans evidenced people had been involved and consulted and their individual wishes and preferences were reflected. The service worked with relevant agencies to ensure people’s individual needs were safely met. Managers were exploring ways of making information accessible to people. Easy read documents were being developed and a translation app used to provide plans into the persons first language. Systems were in place for recording and responding to people’s complaints and concerns. This demonstrated people were listened to and appropriate action taken where necessary. People told us, “There are no problems ringing the office and they always say I must do so if I have any query or concern; but I’ve never needed to complain.”

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives said they had been involved and consulted with when planning the care they wanted and needed. One person said, “I’ve agreed my care plan and it’s been reviewed so it still fits what I need.” People told us support arrangements were flexible and their individual wishes and preferences were considered and planned for. People and their relatives said, “We’ve had meetings about timings of visits; [person] doesn’t accept being in bed when it’s daylight, so it was agreed in the summer they have an earlier breakfast visit, and a later one in the evening for being assisted to bed” and “If I’m going out with my family, the staff get me ready and into my wheelchair. They are very accommodating; I tell them my plans and they fit with me.” They ask what I want for breakfast and provide it. My daughter makes my other meals, and they serve them for me if she is not here.

Staff told us the service worked closely with people and their families to make sure they received care and support that met their needs. One staff member told us, “The more information we have the better it is for the individual.” New staff were always introduced to people and shadowed more experienced staff until they were confident to work alone. Staff were notified when people’s needs changed so that they could continue to provide person-centred care. Any changes to care and support were reflected on the app that staff logged in to prior to delivering care and support. Staff training was provided in Person Centred Care.

Packages of care were arranged through personalised budgets or privately funded where people arranged their own care and support. People said the care and support was developed together with the service, social workers and a range of health care teams, where necessary. One person told us how the service had worked with others to improve care delivery, “The service has been very flexible and accommodating from the start. They went up a gear following the last inspection, for example, there is supervision of care staff whilst they are at work. Also there has been increased awareness and attention to aspects of care like skin care and nutrition.”

People were supported by a consistent staff team. This meant staff were able to get to know the person and build up good professional relationships. The service tried to match staff with people. For example, one staff member could speak another language and so provided support for a person who also understood the same language. The carer recognised the importance of this and told us, “I can communicate with [person] in their own language. She nods in agreement.”

At present the local authority and continuing health care teams do not commission services from Revelations. People are funded through personalised budgets, which enables them to manage their own care arrangements.

Personalised care and support included information about the needs and preferences of different people, including those with protected characteristics under the Equality Act. Staff rotas were stable so continuity and consistency of care could be provided.

People were able to communicate in their preferred language. One person told us how consideration had been given to their specific religious and cultural needs when coordinating their support. They said they preferred staff who were able to speak in their first language, so they were able to converse with them. This was provided. People confirmed they had a copy of their support plan and had been involved in its development.

Managers were aware of the Accessible Information Standards and were exploring ways of developing information for both people and staff based on their individual communication needs. This included easy read formats and a translation App so information could be provided in the persons first language.

The range of systems were in place to help inform people about the service and their care and support. A service user guide was provided advising people of what they could expect from the service and how information about them would be securely held. Care plans incorporated pictures to help explain areas of support and how this was to be delivered. People’s plans also outlined their communication needs.

People and their relatives felt able to speak with staff and managers when needed and were confident they would be listened to. One person told us, “I know the office staff well and they know me. They are always asking if I am happy with the service and if I have any suggestions for making things easier for me or the staff.” People’s relatives spoke about their issues being quickly resolved, adding, “The registered manager and office staff are very committed to providing a good service and their communications with us have improved”, “Management responded to our observations, they were taken seriously” and “Times of calls can easily be changed to fit with going to an appointment. I just ring up and they will make the arrangements straight away.”

Staff provided us with several examples to evidence how they involved people and those important to them, in their own care and support. Where people lacked confidence in going out into the community staff gave them time to build this up so as not to overwhelm people.

Opportunities were provided for people and those important to them to share their views about the service. People were provided with a copy of the Service User Guide. This includes information about how people will be involved in developing their care and support as well as make comment through the ‘Complaints, Suggestions and Compliments’ process or the feedback surveys which were distributed. Managers were introducing a ‘You said, we did’ format to show people comments had been listened to and acted upon.

People told us they were actively involved in assessing and reviewing their care and support in partnership with the service and relevant agencies. People's relatives spoke about further reviews meetings and changes to support packages, where people's needs had changed.

Managers said support was provided from relevant health professionals, where necessary, helping to monitor and review people's health and well-being. A member of the management team was responsible for carrying out internal and external environmental assessments ensuring the premises was safe and easily accessible. Relevant aids and adaptations were accessed to aid people’s safety and mobility.

Systems in place evidenced clearing assessment and planning of people's care and support. Care records reflected the involvement of relevant parties and access to equipment so people's needs were effectively met. Internal and external risk assessments of the physical environment were also undertaken to ensure clear and safe access maintained. Contingency plans were in place detailing action to be taken in the event of an emergency. A formal on-call systems was also available for people and staff. This was available outside of office hours providing a timely response should this be required. Systems were to be developed in recording of any calls, helping to maintain oversight of service delivery.

People and their relatives spoke positively about the management and conduct of the service and felt managers listened and responded to them. People and their relatives felt the registered manager was visible and responsive. We were told, received included; “I always feel [registered manager] wants to know everything possible is being done to provide the best care” and “I’ve seen [registered manager] three or four times in the time I’ve been with Revelation, and we have spoken on the phone. I’m satisfied she knows my situation and the care has always been managed how I’ve asked for it.”

Managers acknowledged some people were not able to express their views. Where appropriate, relevant others were consulted with and their views sought. Managers said they were also exploring how information could be made more accessible depending on the individual needs of people, so everyone was afforded the same opportunity. Managers were aware of people's religious and cultural needs. Support arrangements include people being supported by staff who were able to converse with them in their 1st language as well as have an understanding of their cultural needs. Managers also spoke about recognising the importance of community presence and people being supported to access the local and wider community. Manager talked about some difficulties and accessing specialist support to assist staff in delivering indivdualised support for someone living with Huntington’s disease.

Comprehensive support plans reflected where lawful decisions had been made to help protect people's rights. Information was provided in relation to advocacy support available to people, where necessary, ensuring they have a ‘voice’. The programme of staff induction and training incorporated training in equality and diversity and person centred planning to help develop their knowledge and understanding in delivering personalised care and support.

At the time of this assessment the service was not providing support in end of life care.

We were told the service was not currently supporting anyone at ‘End of Life’. Managers spoke about one person whose health had improved, resulting in them being discharged from services. Managers said people and family members would be involved in any discussions about their future wishes so that appropriate support could be provided. Manager were aware of best interest meetings where people are unable to make decisions for themselves. Complex care support for people with mental health needs was no longer being provided by the service.

Relevant policy and procedure and staff training were available to guide staff in end of life care. Where people had expressed their future wishes these were recorded in people's individual care records. People's records reflected their religious and cultural needs or protected characteristics, so their individual needs are met. Appropriate information was also available where people had a 'do not attempt cardiopulmonary resuscitation' (DNARCPR) protocol in place.