Dynasty Brighton Branch (Domiciliary Care)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. Whilst an initial assessment was undertaken before care provision started, people told us that they had not always had a review of their care needs. Care plans contained details relevant to people’s needs, however, it was not clear that these were regularly reviewed. Staff told us that they would report any changing needs to the management team.

The provider used legislation and current evidence-based practice to plan and deliver people’s care and treatment. However, due to recent staffing issues people did not always feel that care was consistently provided in a way that was most important to them. The provider had up to date knowledge to keep in line with any changes in legislation, however not all staff had completed their training in line with guidelines .

The provider worked across teams and services to support people. They had made referrals to appropriate external agencies for additional support when necessary. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Care records contained the details of those involved in people's care. Staff maintained records of the day to day care they had delivered in people’s daily care logs to provide information to relevant others to follow up when required.

The provider did not always have robust systems in place to support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did what they were able to support people to live healthier lives, or where possible, reduce their future needs for care and support. For example, they would help a person contact a GP, or report to their relatives that this might be needed. They also stated that they would report it to the management but did not always feel this was robustly followed up. One staff member said, “I sometimes wish they were quicker to react when we report issues ”. We did not see evidence of this impacting a person negatively, however, was an area for the provider to consider for improvement.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always clearly communicate with people regarding their needs and wishes. Reviews of care had been inconsistent and the expectations of people regarding their care had not always been met. For example, one person had suspended a particular care call as staff were inconsistent in attending it. People told us that the provider was not always effective in addressing concerns raised by them about the timing and quality of care.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff demonstrated a good knowledge of the mental capacity act and how to apply this in their practice. Daily notes demonstrated that staff gained consent prior to undertaking any care support. One person told us, “Yes, I am asked what I want as I can do a lot of things myself. I want to be as independent as possible.”