Fosse Healthcare - Nottingham

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

People were supported to live in a safe, inclusive environment in which they were treated fairly and free from the fear of being discriminated against. People were supported to understand their equality and human rights and how staff and managers would respect these. Managers made sure staff were given appropriate training and supported to treat people equally and fairly and reduce the risk of them being excluded from receiving care and support they were entitled to. Managers used people’s feedback to improve care to reduce any barriers people might experience due to their protected characteristics.

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 told us their care was person centred. This meant it was tailored to their needs, wishes and preferences and empowered them to make choices. One person told us, “They [staff] suggest things for me and I say yes or no. They’re led by what I want and react to that”. A relative we spoke with said, “Yes, the care is tailored to [relative] needs, and if they [staff] find anything else in the house that needs doing, they help."

We spoke with staff who gave us examples of how they supported person-centred care. One staff member told us about a person they cared for who had communication difficulties and using other means to communicate with them including use of a whiteboard. Staff were aware of the importance and positive impact on people’s health and wellbeing of placing people at the centre of their care and empowering people with decision making.

Feedback from people and relatives about staff understanding of people’s diverse care needs and continuity of care was generally positive. One person told us, “Some of them [staff] are really brilliant, some haven’t been for a while so don’t always remember what I need”. A relative we spoke with said they felt staff understood their relatives needs and called them daily to let them know what time they were coming so they could plan their care. Another relative we spoke with felt a lack of continuity of staff could impact continuity of care but that their relative didn’t seem to mind.

The management team and care staff understood people’s diverse health and care needs and also said they could access care plans to provide them with information about people if needed. The manager talked with us about continuity of care and providing a flexible service as well as funding of people’s care and gave examples of flexibility and engaging with the local authority over funding for people’s care for example during a period when they needed additional care which their current care team could provide.

Partners provided positive feedback about the provider ability to provide a joined-up, flexible service that supports choice and continuity including for people with more complex needs. One partner working with the service told us, “Not every story is one of greatness or success however I feel that the way Fosse work with their customers and [Funding Local Authority] make the chance of achieving a ‘more ordinary life’ greater.”

We saw that staff received training and support to understand people’s diverse care needs and care plans provided detailed information for staff about this too. The rota supported continuity of care as far as possible and there was flexibility for people in planning their care for example, to attend an event.

People told us they received information on starting care, there were newsletters sent out and everyone spoken to had contact detailed for the office with most people having regular contact with staff in the office.

We spoke with the registered manager and quality manager who gave examples of how information is provided to people and relatives using the service as well as means of sharing information internally with the team. They were aware of the importance of considering people’s privacy when sharing information and also providing accessible formats for people if required, such as providing information in another language.

We observed examples of communication with people and relatives through email and records of phone calls. We reviewed a monthly newsletter which was sent to people. We also noted that people and relatives could get access to a portal to the electronic system where information about people’s care was recorded including where staff recorded notes. This meant people could review what had been recorded and also provided relatives, where appropriate to do so, with access to information.

Not all people we spoke with recalled being asked for feedback or involvement and co-production when it came to their care. However, people were aware of what to do if they had any concerns. One person told us, “Someone from Fosse comes every few months to check that everything is ok, any problems, I can phone up; I feel very supported.” Evidence we reviewed indicated people were listened to and involved in providing feedback on care.

The registered manager spoke with us about how people were involved in improvements to their care and at service level and described ways that people were engaged with for example, review processes, spot checks to get feedback on care and providing people with information on how to raise a complaint including with external agencies like the local authority and CQC.

We reviewed documentation which evidenced people were listened to and involved in improvements of their individual care and the service such as service user satisfaction surveys and responses. A person highlighted concerns about call times which was discussed with them and addressed. Compliments and complaints were documented, as well as responses, including sharing feedback with staff.

People did not provide any specific feedback on equity in access and there were no concerns received regarding inequality of experience or outcomes.

The registered manager was aware of barriers to care and how to tackle inequalities in experience. Whilst there was no one specific identified receiving care at the time they had identified that social isolation experienced by some people receiving community support could impact on wellbeing and how people were supported in those instances sometimes needed to be adjusted for example, when the manager had approached a person’s social worker for funding for support to access community activities.

We spoke with one partner working with the service who told us about how the team at Fosse Healthcare- Nottingham had supported positive outcomes for people and effectively combatted barriers to quality care and outcomes through their ways of working. Describing the difficulty of supporting people who are resistant to receiving care they said, “I feel that Fosse staff show a tenacity and resilience when working with those who are not always easy to engage with. I feel that this must be a skill that the leadership look for.”

Auditing processes included the review of daily records and medication records. These processes identified where people had declined support which was addressed through discussion with people, relatives or external professionals. Addressing these issues improved the likelihood of people who are most likely to experience inequalities in experience or outcome were identified and means to overcome issues addressed to support equality of people’s experience of care.

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

Not everyone we spoke with had future plans in place or wished to discuss this. One person we spoke with about advanced care planning, including having RESPECT form and DNACPR in place, told us, “They are in place, and they’re kept in a safe place; the carers know where they are.”

We did not obtain any feedback regarding future planning; however, documentation supported that management, and staff had a good understanding of people’s future needs and appropriate documentation was in place.

The policy had an up-to-date end of life policy. Care plans contained clear information regarding people’s wishes and any advanced care plans I place. We noted information was highlighted for people who had a DNACPR, RESPECT form or end of life care plan in place but also clear documentation when people didn’t. For example, one care plan reviewed stated the person did not have a DNACPR or funeral plan and did not wish to discuss at the time of assessment. Having clear information recorded meant people received the care they wished to receive how they wanted it in the event of an emergency or when receiving end of life care.