Dignity Direct Homecare Ltd - Sheffield

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 54 (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 care records had moved onto digital systems, care plans required improvements to ensure they were more detailed and individualised. The provider had recognised this and was working through records to ensure they provided more detail. Care plans were not reviewed on a regular basis, some care plans contained conflicting information, meaning staff did not always have access to correct guidance about people's needs and preferences. We received mixed feedback about care planning and reviews. One relative said, “A care plan was made. I signed the papers. There hasn’t been a review.” Whilst another person said, ““I’m involved in the care plan. I have a copy. I’ve spoken with the helpful office staff and the social worker to get a review done.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. It could not be evidenced that external professionals were always sought, due to concerns we found in the safe section of this report. However, we did find several incidents where emergency treatment was sought for people following accidents and the service worked closely with district nurse teams, to meet people's clinical needs. We also found where people required, they had input from community mental health teams. We received mixed feedback from people about staff working with external professionals. One person said, “I don’t think the carers know my health needs and don’t contact health for me. The doctor sent the district nurses for me.” Another relative said, “[Name] has recently been to hospital with a UTI, I don’t think the staff are trained to spot this.” Whilst another relative said, “If [name’s] legs are swollen they will ring up the district nurse and have phoned the doctor. Carers put a compression bandage on for the swelling.”

The provider did not always work well across teams and services to support people. It could not be evidenced the service worked in partnership with services, due to the concerns we found in the safe section of this report. Staff completed daily care records on a digital system, which allowed the management team to monitor people's care and daily tasks. This system alerted managers of any missed care tasks or missed care calls. However, due to concerns we found and feedback we received, we could not be assured care was recorded effectively. Most staff told us the team worked well together, and staff were involved in regular team meetings. One staff member said, “Staff morale at this place is fantastic, employees feel motivated and supported, definitely it is good place to work, I enjoy with the people I work with and the office staff who are supportive.” Partners told us the service worked well with them.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support. Care plans required some improvements to ensure information relating to people's health conditions was specific to them and contained all accurate information about people's health. For example, one person's plan gave a summary of how to manage a heart condition, whilst another person's plan did not detail how staff provide catheter care. Staff supported some people with meals. People told us they mainly received adequate food and fluids, however some people told us staff sometimes forgot to leave them a drink, or did not offer them an alternative choice of meals, such as a sandwich. One person said, “They usually leave me a drink of water, but they forgot today.” A relative said, “The carers heat food up. [Name] can eat what they want. The carers leave [name] with a hot drink in a mug that stays warm.”

Care records contained details about how people could maintain their independence and their future goals and aspirations. For example, one person wished to maintain a close relationship with their loved ones and another person wished to remain as independent as possible.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Where people lacked capacity, some assessments had taken place. However, these required improvements to ensure staff worked in line with the Mental Capacity Act. We found several areas of capacity assessed together, not specific to each decision. Staff were trained and understood their roles in relation to gaining consent from people. One staff member said, “I make sure the care I provide is person-centred, I involve them in decision making, I listen carefully knowing that each person has unique needs and preferences.” However, some people told us staff do not always seek consent from them or explain what they are doing. One person said, “No they don’t explain first. Never explained. They don’t ask for my permission. I’ve just got used to it.” Whilst another person said, “Carers ask me what I’d like. They sort my clothes out for me and what I’d like to eat.”