Dignity Direct Homecare Ltd - Sheffield

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

Responsive – this means we looked for evidence that the service met people’s needs. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Staff told us they could access people’s care records via the online system, which contained peoples needs, preferences and choices. However, we could not be assured this information was up to date. Staff told us how they promoted person centred care for people, such as listening to people, involving them, promoting independence and choices. We received mixed feedback from people about how staff provided individualised care and support. Some people told us they received different staff, who did not know them well, however people told us this was improving, and they were starting to receive more regular staff. One person said, “I don’t know how much training staff get. They’re (carers) not really strong on people skills and could improve.” A person said, “Most of them (carers) are very good. The first lot were very friendly and kind. But some new ones are just doing the job. Not so kind or friendly and don’t chat.”

There were some shortfalls in how the service understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. Due to concerns highlighted in the safe section of this report we could not be assured people had accessed all external health professionals when required. Records evidenced staff had contacted emergency services as required, however there was a lack of accessing GP's, Chiropodists and SALT teams for some people. The service worked closely with district nurse teams and social workers. One professional told us they had regular meetings with the service, which were positive overall.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People had detailed communication care plans in place. Records detailed people’s preferences and guidance for staff about how to interact with people. For example, one person had low vision, and the care plan detailed how staff ensure plenty of light, assist with medicines and meals and speak clearly. Information was stored confidentially and in line with GDPR regulations.

The service did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve people in decisions about their care or tell them what had changed as a result. Improvements were required to ensure the service provided people with the opportunity to feedback and contribute to their care. There were no recent feedback surveys for people, relatives or staff. Some people told us there was a lack of communication from the service and they did not feel listened to. One relative said, “ My relative speaks to (manager) if things are not right. The manager has not visited us. It could be better run. They need to plan well ahead on visits rather than a day or two beforehand.” Whilst a person said, “No, I have had nothing like that (opportunity to feedback about care).” Another person told us they had struggled to contact the office over weekend hours. People did have some 1:1 time with senior staff and these showed positive feedback from people, such as 'staff are amazing' and 'I always have a choice of meals.'

The service did not always make sure that people could access the care, support and treatment they needed when required. Some improvements were required to ensure people’s cultural and religious needs were explored with them and recorded on care plans. However, people were supported in line with their cultural needs and preferences. One person was supported by staff who were able to speak their preferred language, assist them with prayer and provide meals in line with their culture.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Some people told us action had been taken following them raising concerns. One person said, “We complained about the late calls, and they have recently been sending the same 2 staff to us.” Another person said, “Someone from the service came. My views were put in the plan. I have a review every six months. I get a call from the care co-ordinator.”

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Staff supported people at the end of their life and some care records detailed about how staff keep people comfortable and monitor for signs of pain. However, end of life care plans contained conflicting information and did not have up to date guidance about people's current needs, which could be confusing for staff. For example, 1 person’s plan contained conflicting information about who was administering medicines, and how this person was currently mobilising and receiving personal care. It was also unclear if this person had made any advance decisions about their care, such as attempting resuscitation.