Dove Home Care Agency Limited

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• 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 good. At this assessment the rating has 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 failed to ensure people were consistently placed at the centre of their care and treatment, and did not work effectively in partnership with people to respond to changes in their needs.

Care plans were not sufficiently detailed or accurate, which placed people at significant risk of receiving inappropriate or unsafe care. For example, important health concerns identified by district nurses, such as swollen and weeping legs and the need for wound care, were not reflected in care plans. This meant staff did not have the information they needed to provide safe and appropriate support. There were inconsistencies between care plans and risk assessments. For example, in one care plan it stated family supported with nutrition and hydration, whereas the risk assessment stated carers were responsible, potentially creating confusion about staff responsibilities and increasing the risk of tasks not being completed. Care plans also lacked clear, personalised guidance on how to support people with equipment, personal care, and specific health conditions such as epilepsy or diabetes. Consideration of equality, diversity and inclusion was not consistently evident within care planning.

The provider responded positively to feedback and began improving personalisation of care plans. Actions included gathering additional information from people using the service and introducing AI-supported assessment and review processes to capture more personalised details.

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.

People and staff described inconsistent continuity, particularly at weekends or during changes in staffing. One staff member explained, “I may get some continuity on Monday, Tuesday and Wednesday…but on Saturday and Sunday I could be anywhere,” highlighting the lack of consistency. People also shared concerns, with one stating, “I’ve had five different carers since Christmas,” and another reporting anxiety about changes in staff and limited choice when a regular carer was due to leave. Feedback indicated this inconsistency made it harder to recognise changes in people’s health, with one staff member noting continuity is important to identify concerns early.

However, there were positive experiences where continuity was achieved. Some staff described regular rotas that helped them build trust and understand people’s needs, and a relative commented, “We have had the same carers for 18 months and they [the staff member] are brilliant.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

At assessment, staff identified how people communicated. The manager explained “For example whether people “talk and communicate verbally” or “only communicate through a keyboard.” The service adapted support to meet diverse needs, including matching staff who spoke the same language and using tools such as whiteboards, easy read documents and large text. Staff demonstrated a good understanding of people’s communication needs, with one saying, “I communicate in the way the person will understand, sometimes this will involve using simple language or communication aids.”

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.

People consistently described positive communication, with one person saying, “Whenever I need to ring the office, it’s always been a very positive experience,” and another noting staff were “very accommodating, from management to carers.” Relatives told us, “I’m very pleased… they listen to us,” and concerns were acted on quickly, such as resolving issues with staffing or changing carers when relationships did not work well. People also found the office accessible and responsive, with timely replies to queries.

However, one relative felt unable to speak openly during a review because the carer was present, suggesting some meetings could allow private discussion to further strengthen openness and involvement.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

A health professional told us, “The carer provides a 1-1 service, and this works very well… they support them to access the community and attend places like Day Centres.” A family member also described the support as responsive, saying, “Yes, they are quick to respond… the Doctor has asked for her BP to be done every day and that has been happening,” and confirmed staff supported their loved one to go out for a short daily walk.

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.

Staff demonstrated a good understanding of equality and diversity, with one explaining that they ensured people with communication difficulties were given time to express themselves and were fully listened to. They described advocating for individuals when needed, ensuring their views were respected and that care remained person-centred. Staff also recognised the importance of raising concerns, with one stating that any issues would be reported and followed up appropriately to ensure people were treated fairly. Another staff member shared that they had identified when a person’s cultural food preferences had been overlooked and reported this so it could be addressed, adding that concerns were taken seriously and acted upon. These examples showed staff were aware of potential inequalities and took appropriate action to promote equity in people’s experiences and outcomes.

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.

Care plans did not consistently include clear or detailed information about people’s advanced wishes, meaning there was a risk that their preferences may not be fully understood or followed. For example, one care plan recorded a Do Not Attempt Resuscitation (DNAR) decision but did not include any further detail about the person’s wider end of life wishes. Some people had a Recommended Summary Plan for Emergency Care and Treatment (RESPECT) form in place; however, the associated care planning did not clearly outline what had been discussed or agreed. In the care plans reviewed for people receiving end of life care, there was a lack of detail about their advanced wishes. In other cases, care plans showed that conversations had started but had not progressed further, with entries such as the person had “not shared this yet” in relation to their wishes. While this indicated that staff had begun discussions, there was limited evidence these were followed up to ensure people’s wishes were fully explored and recorded.