Service user and carer experience of South Worcestershire community assessment and recovery service

Healthwatch Worcestershire identified a need to gather feedback on South Worcestershire Community Assessment and Recovery Service (CARS), following a report by the Care Quality Commission (CQC) in January 2020 which identified concerns. They spoke to 199 people via two surveys – one for service users and the other for carers.

CARS aspire to allocate a Care Coordinator within four weeks of a referral to the service being accepted, but only 53% of respondents say they do not have one. Of those who say they have a Care Coordinator, only 40% were allocated within six months.

Just over half of respondents have a Care Plan and where they existed the majority are reportedly limited to treatment which falls short of CARS’ own intentions. Some respondents with a plan reported they were out of date and sometimes had not been revisited for years. Of those who say they have a Care Plan only 40% felt their views were fully heard in the planning of their treatment.

Whilst CARS aspire to involve all Carers in the Care Planning process and 71% of respondents report having a Carer, only 36% were able to contribute to the Care Plan.

Concerns about aspects of communication were a common theme and encompassed information, awareness and access to support. Some Service Users have a lack of clarity about CARS and what is included/not included and indeed what the service they are receiving is called.

Just over a third of service users said they were made aware of their rights and only 37% said they knew how to make a complaint.

It would appear that there is still work to be done in addressing the concerns raised by the CQC. Concerns were expressed by some about accessing support, some had difficulties when contacting the service – particularly if they didn’t have a Care Coordinator.

A consistent theme regarding staff turnover emerged from respondents and the impact this had on their treatment. For many this resulted in a loss of treatment and a lack of continuity. Some people were left without any support or contact from the team.

Two key themes emerge from Carers and relate to involvement and support. Whilst 24% of Carers express satisfaction with CARS, the majority have significant concerns about their experience. Half of Carers report they were not included in the care planning process and comments reveal some feel there is significant expectation of them.

It is of concern that so few Carers are identified by CARS not least because of the lack of support being made available to them and a duty of care. There is a risk too that safeguarding considerations may be overlooked.

It is important that Carers are supported to stay well in their caring role and findings reveal that information about support groups is only made available to some. No one said they had received information about coping skills or courses/groups that would help to develop these skills. Whilst 67% said they knew who to contact if the person they support were to feel very unwell again, 33% did not. 57% of respondents say they were not made aware of their rights and 41% did not feel they were treated with dignity and respect. Only 53% were sure they knew how to make a complaint.

The report contains 12 recommendations centred on communication, care coordination and planning and information to carers.