OASIS West London Office

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

We assessed 7 quality statements in the responsive key question. We identified 1 breach of legal regulations, person centred care. There was very little information in care plans about people’s preferences, likes and dislikes. Most care plans did not have details about how people preferred to have their needs met. Staff guidance on meeting people’s needs was very vague or not recorded. However, staff were able to tell us how they would meet people’s needs. People and relatives were involved in providing feedback on a regular basis. The provider made referrals to other health care professionals regularly and as required. This helped to ensure people’s needs were met.

This service scored 71 (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 relatives told us they were involved in care planning and reviews of their care. Everyone we spoke with told us the care workers understood their needs and how to meet them.

Staff knew people well and could explain what people’s likes and preferences were and how best to meet them. Staff told us they would check care plans for information on meeting people’s needs. The registered manager explained that care was delivered to people in a person-centred way.

Care records reviewed showed the provider had engaged with other health and social care providers . For example, the provider had made referrals to health care teams such as the occupational therapist, district nurse or the dietician teams to support people with their health needs.

Staff and leaders told us they regularly engaged with other health providers and the local authority . Leaders were able to show evidence that they understood how to navigate the local health care systems. This helped to provide coordinated care.

Communication records reviewed showed the provider had a good working relationship with both the local authority and health care professionals. There were no concerns raised with us during our assessment.

The provider could evidence several examples of referring people to various health care teams when people’s needs changed. This meant people could be confident support would be sought from the appropriate health care professional, who had the expertise and skills to support them to meet their care needs, where this was required.

People were given information from the provider when they had their initial assessment. One person said, “We were given an information pack about the company when he started with care." Another person said, “Yes I have an information pack in my home."

Staff and leaders told us they communicated with people well. Staff knew what support people wanted. Staff were able to describe people’s needs including their communication needs . Care records sampled did not show how staff promoted people’s understanding of the care and support they received using different communication methods. For example, one person’s care plan detailed that English was not their first language and they needed staff to communicate with them clearly. There has been no reference in the care plan of how staff promoted effective communication with this person.

Care plans sampled showed that people’s communication needs had been assessed. However, in some cases, there was not enough guidance for staff to follow. This meant staff may not be able to effectively communicate with people to meet those needs. Following our last inspection the provider had created different care plan formats for adults and children. For example, there was a picture or symbol format available for a child to make it easier for the child to understand their care. Systems were in place to hold confidential information and the provider had systems to ensure compliance with the UK General Data Protection Regulations (UK GDPR). Service records were kept locked away or password protected on electronic devices. This helped to ensure people’s private and sensitive information was only shared with authorised persons.

People were given opportunities to speak to staff and leaders. People and relatives told us they were involved in decision about the running of the service. The provider contacted people regularly to obtain their views on the service. Questionnaires had been sent out to people to obtain their views and issues of concerns were addressed by the provider.

Staff and the registered manager told us they spoke to people and relatives’ regularly. We saw evidence of communication between people and staff. Staff responded to people’s requests and kept them informed of any changes to their care and support needs.

The provider asked people for their input, however, this was not always acted upon. Care plans were not always updated to reflect their preferences and wishes. However, there was a process in place to obtain people’s and their families’ views about the quality of the service provided. Surveys were sent to people yearly, to ask people to make comments on the quality of care. The results were analysed, and areas for improvements were identified and addressed by the provider.

People and relatives told us they could access health care support when needed. Most relatives we spoke with told us they would support their relatives to health care appointments. People’s records showed there was input from health care professionals.

Staff and leaders were able to describe how they supported people with reasonable adjustments. For example, a referral was made to the occupational therapist service when it was identified that a person’s accommodation was not meeting their mobility needs. Staff understood the person’s needs and were able to arrange the furniture to give more space to the person until the assessment was completed.

Feedback from the local authority has been positive about the agency. The local authority told us the agency had made improvements overall regarding care planning and reviews.

The provider had a system in place to support people to access health care providers. The registered manager shared some examples of how people had accessed health care professionals which helped people to meet their needs.

People and relatives were very positive about the care agency staff. Overall people were satisfied with how care was delivered. Some people we spoke with told us that English was not their first language, but felt comfortable with the agency as staff were able to speak in languages other than English.

Staff and leaders told us they respected people as individuals and would not discriminate against people for any reason. Staff told us it was important to be aware of people’s diverse needs. For example, staff were able to explain how important it was for people to follow their beliefs and culture. Staff would ask people how they wanted to be supported. For example, staff would ask whether people wanted to have certain meals or observe religious festivals. This meant people could be confident staff listened and valued their individuality and preferences.

The providers care planning process did not always evidence people’s likes, dislikes and preferences. Some care plans did not contain enough relevant information for staff to follow which meant there was a risk that staff might not have all the necessary information to meet a person’s diverse needs. The provider had policies and procedures in place about equality and diversity. Staff also had training in equality and diversity. This helped to ensure staff had a good understanding of people’s diverse needs and were supported to meet these.

We received little feedback from people about end-of-life care. Care plans we sampled did not have information about people’s end of life wishes and preferences documented and therefore the provider could not demonstrate how people had been involved in assessing their needs in relation to end of life care.

The registered manager told us that at the time of the inspection no one was being supported at the end of their life or in receipt of palliative care. The registered manager shared an example of a person who had recently requested to move in with their family as their illness had progressed. Staff did support the person with their wishes and preferences. The registered manager had made referrals to the appropriate local authority to make sure there was funding in place and care and support was delivered to the person by the agency.

None of the care plans detailed any end-of-life care arrangements or advanced decisions that people might have made about end of life care. There was also no guidance for staff about what to do where people start to develop end of life care needs. This meant there was a risk that people’s end of life care needs might not be met should they develop these, Whether people had a ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) order, was not always recorded on their care plan. The provider acted on the day of our visit to ensure that this was recorded on care records as soon as possible and a copy was held in people’s homes as well as on care records. The provider had an end of life policy in place which gave staff some guidance if required .