Access Dignity Care Limited Also known as Access Dignity

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. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this. The service was in breach of legal regulations in relation to consent and staffing. Improvements had been made and the provider was no longer in breach.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The provider told us they always completed a face-to-face assessment either in a hospital setting or within people’s homes. People told us the assessment was comprehensive and they were always included as part of this process. A person told us, “I really didn’t know what to expect or what to do when the hospital referred him to this agency. The service suggested that they do things for [family member] to meet their needs, but at first things were not quite right, but now everything has been smoothed out and I am more than happy with how they are cared for.” A relative said, “There was a lengthy meeting prior to [family member] starting with the service. They went through everything and looked at the risks they might encounter.” A staff member told us, “We involve families if clients choose this and we include anyone they want. If they cannot be present, we will make phone calls etc. It is a very collaborative approach with all our assessments and reviews.”

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People and relatives told us staff had a good understanding of their needs. A person told us, “They look after me as they should.” A relative said, “I feel that they are offering and providing good practice. They do all they can for my parents to ensure they are comfortable in their own home.” Additional training had been carried out since the previous assessment so staff had an awareness of people’s health conditions. Staff told us they had a good understanding of people’s needs and the care plan was comprehensive. A staff member told us, “The service we provide now is much more person-centred, we all have so much more information about people’s health conditions and any signs and symptoms.” Care plans contained information about people’s nutrition and hydration needs and people told us staff supported them with this. A relative said, “[Family member] eats softer meals as they have difficulty swallowing. They see to their personal hygiene every day, sometimes twice a day, which is brilliant.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. People and relatives told us staff worked well with any professionals involved with their care. A relative said, “I think they work very well with all the people who look after them, we are always getting visits from different professionals, and they all seem to know what the others are doing.” Staff were positive about working for this service and felt teamwork was good. A staff member told us, “The management is always available to listen, offer feedback, and help with any challenges I face. This makes me feel like a valued part of the team.” Another staff member said, “It seems to me very positive; we are all from different places and work well together.” A professional told us, “I have complimented the service for their willingness to work with us as a local authority.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. The service had processes to refer to other professionals if they were concerned about a person’s health. This included the GP, district nurses, social workers or any other professionals required. Systems were in place to help ensure people’s health and wellbeing was monitored. People and relatives were positive about their support with any health conditions they may have. A relative told us, “My parents are unable to support their own health needs, which is why I feel the service does such a good job, as they take some of the pressure off me.” Staff confirmed they had received additional training in relation to people’s specific health conditions. A staff member said, “They give us training on most health conditions. We have had training on dementia. It helped me to understand it more.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Staff told us they know people well and supported them to improve outcomes. A staff member told us, “We support service users with exercises from physiotherapist.” People told us they received consistent and effective outcomes from staff. A person told us, “They encourage me to drink; they leave drinks for me.” A relative said, “They are very competent. They understand [family members] dementia needs, they understand about their catheter. One is changed every day and the other lasts longer. They understand how to treat [family members] skin and prevent further bed sores.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. When people receive care and treatment in their own homes an application must be made to the Court of Protection for them to authorise people to be deprived of their liberty. The provider and staff had a good understanding of the MCA and appropriate consents were in place. The registered manager was able to give us details of following a best interests’ process and involving professionals when a family member was using a technique to move a person which was felt to compromise their safety. They told us, “We have done a lot of professional working around decision-making. However more work was needed in record keeping related to people’s capacity and decision-making. Whilst the provider had recorded best interest information, records sometimes contained multiple decisions which is not in keeping the MCA. More work was needed to ensure records related to decision-making were decision specific. People and relatives were positive about staff and confirmed they always asked for consent prior to delivering care. A person told us, “If I say no they respect my wishes.” A relative said, “They talk to [family member] as they support them, so they are aware of what they are doing.” Staff had received training in relation to the MCA and deprivation of liberty standards.