Dedicated Care East Anglia Limited

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 provider met people’s needs.

At our last assessment we rated this key question outstanding. At this assessment the rating changed to requires improvement.

This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person-centred care.

This service scored 61 (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 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. Care notes did not evidence how people were consistently given choices over their day-to-day lives. Entries appeared task-focused and did not consistently evidence how they empowered people and that people were actively involved in decision-making.

However, care plans referenced person-centred approaches to support people who became anxious in certain situations. Evidence viewed showed they were supported appropriately.

There were some shortfalls in how the provider 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. Pre-admission assessments were not robust and did not evidence involvement from other healthcare professionals. The service could not evidence choice provided to people and failed to identify the impact this had on their well-being. However, people were supported by the same staff and staff worked regularly in the same homes and covered shifts in other services and this ensured a continuity of care.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. The provider had a service user guide that informed people of the service that they offered and how people can start to receive care and support from them. They had a complaints procedure that was clear and met the accessible information standards for people using the service. Staff had training around communication needs and General Data Protection Regulations (GDPR.)

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result. The provider conducted regular meetings with people in the service. They carried out surveys with staff, people and relatives and healthcare professionals to obtain feedback on the delivery of care. The provider analysed the feedback where able. We reviewed the services complaints log, and no complaints were from people who used the service only complaints recorded were from staff. Everyone we spoke with knew who to raise concerns with. The relative we spoke with said. "I would raise concerns with the provider, if I had any."

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. Staff failed to follow internal policies and ensure that medical advice was sought where appropriate following incidents, and where assessments recommended in doing so. Healthcare professionals involved in people’s care were not notified if they had been involved in an accident. The provider acknowledged this was a short fall and had begun work with staff on reviewing their internal procedures.

However, there were clear processes for staff to follow during out of hours and had an on-call rota.

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. We found people were supported to attend family gatherings, social situations and routine health care appointments with appropriate support in place from staff, they ensured barriers to care, support and treatment were overcome by providing continuity, reassurance and guidance to people they supported.

People were 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, although only a small number of staff had completed end of life training this was not sufficient to ensure people had a good quality end of life care

However, we found, where appropriate, people had advanced decisions recorded within their care plans so when the time came staff knew how people wanted to be supported. Notifications submitted to CQC around people’s deaths were submitted promptly.

People were supported to set achievable goals. However, we could not consistently evidence the choices or conversations held around goal setting. However, we found other instances where people had set goals unique to them and they were supported appropriately and the outcomes were positive.