Dove Home Care Agency Limited

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• 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 good. At this assessment the rating has changed to requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to the need for consent.

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.

Not everyone felt involved in the assessment or review process; one person said they only knew “the basics” of their care plan, while another commented, “We have a care plan in a folder, I’ve not been involved in it… but they send me the details on what’s been agreed.” A relative also noted, “I’ve not seen it,” and was unsure who held the care plan. Some review documentation appeared more focused on relatives than on the person receiving care, and inspection findings showed care plans did not always reflect current needs.

However, initial assessments were completed before people started using the service, with one person describing the process as “very efficient”. Some people shared that there were systems for regular reviews in place, including “6 months / yearly reviews,” with some people feeling care plans were accurate and that their relatives were included.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Systems were not consistently effective in ensuring continuous assessment, monitoring, and improvement of care, with an over-reliance on staff to use their judgement rather than follow clear, robust care plans. Recording practices were inconsistent; although staff understood the importance of documenting care, this was not always completed in sufficient detail. For example, daily records for one person did not clearly evidence what food or nutritional support had been provided alongside their specialist diet, which meant care could not be effectively monitored or audited and placed the person at risk of inappropriate support. There were also gaps in responding to identified needs, such as a person requiring softer foods due to ill-fitting dentures, where there was no clear evidence of timely support to access dental care.

However, care plans did generally reflect specialist dietary requirements, including cultural preferences.

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.

A health professional told us their experience of the service had been positive. They said the service was responsive and addressed any concerns by putting appropriate measures in place. They also explained that a family member had shared with them that they were happy with the support provided, and described staff as particularly dedicated to supporting the person and meeting their needs.

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.

Staff worked with people to establish consistent routines, helping them feel safe, understand what to expect, and maintain independence as much as possible. For example, one person living with dementia was supported with daily personal care in a respectful way, with staff offering support each day while recognising their right to refuse; this approach balanced safety with personal choice and dignity. Relatives commented positively on the impact of care, explaining that staff helped their family member settle into a routine, which improved sleep and appetite and led to essential weight gain.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Whilst outcomes were in place, care plans did not always reflect current needs or meaningful progress, with some goals and outcomes for people being outdated or unclear. For example, one goal referred to returning home within 12 months, despite the person already living at home for nearly a year. Outcomes were often broad, such as “to be supported in the community,” and lacked clear, measurable objectives, limiting the ability to track progress or evidence improvement. There was also limited evidence of co-produced goals or structured review processes to ensure outcomes reflected people’s choices, quality of life and changing needs.

Where identified, the provider responded to feedback and showed a willingness to review and improve how outcomes were recorded and monitored.

The provider did not always tell people about their rights around consent or consistently respect these when care was delivered, particularly where people may have lacked capacity.

Mental capacity assessments were not decision-specific and only highlighted if someone did or did not have capacity. One person was found to have a tracking device in place according to their care plan and did not have a recorded best-interest decision or mental capacity assessment in place. This places the person at risk of unlawful restrictions and monitoring, which is against their privacy, human rights and autonomy.

However, staff demonstrated a good understanding of gaining consent during daily care. One staff member explained, “Consent is sought verbally each time… and I pay attention to both verbal and non-verbal cues,” while another said they “always assume a person has capacity unless proven otherwise.” Staff also described explaining care clearly, seeking permission, and respecting refusals.

The provider was responsive to our feedback and took action to strengthen Mental Capacity Assessments to ensure they are decision specific.