Reviews of people’s care and support plans should be completed more frequently than once a year, a report by Healthwatch, the service user watchdog, has said.
The report said reviewing care plans should instead be a “continuous process”, particularly in cases where a person’s ability to do things for themselves might be changing rapidly.
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Under the Care Act 2014’s statutory guidance, councils should review care plans no later than every 12 months though this is not a legal duty.
The report looked at the experiences of people using home care services. It included information from 52 local Healthwatch organisations, and the experiences of 3,415 service users, their families and frontline staff, collected through events, surveys and site visits.
It also found that care workers were frequently unfamiliar with their clients’ care plans and when it was a staff member’s first visit, there was often not enough time to read the plan. In some cases, this was leading to “serious problems”, such as medication being missed.
A survey of 363 people in Newcastle, found one in seven had experienced medication being missed because of the home care provider. One in six respondents also said they felt the provision of medication was either “partly” or “never” safe.
The report recommended that automatic notification systems could be introduced to update staff about important changes to care plans, or prompts could be left around people’s homes as a reminder of their preferences.
Lack of time
The report also said local authorities needed to be more realistic in care plans about how much is achievable in the limited time available in most home care visits.
It found that only half (56%) of 73 people responding to Healthwatch Blackburn with Darwen’s survey felt there was sufficient time to complete all tasks set out in the care plan.
A service user told Healthwatch Redcar and Cleveland: “Sometimes they give me a shower but they go over their time but most of the time they haven’t got time to give me one so I go a couple of weeks without one and that’s not right, I feel dirty.”
Home care workers in Torbay also reported “unrealistic staff rotas” that left them exhausted and having to carry out double-handed care tasks on their own.
Some service users also reported that staff lacked basic skills such as being able to boil an egg or make a bed, which resulted in poor care.
Neil Tester, deputy director of Healthwatch England, said: “We heard examples of compassionate care from dedicated staff, but people also talked about care that doesn’t meet even basic standards. Given the challenges facing the social care sector, it’s more important than ever than ever that people’s voices are heard.”
Margaret Willcox, president of the Association of Directors of Adult Social Services, said: “Most adult social care services in England are providing people with safe, high quality and compassionate care. That they are doing this in the context of rising demand and inadequate funding is a tribute in itself, but there is always room for improvement.”