Daffodil Care Ltd

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.

This is the first assessment for this service. This key question has been rated requires improvement

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

This service scored 54 (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.

People's needs were not always comprehensively assessed, reviewed or clearly reflected in care records. We found care plans and risk assessments lacked sufficient detail about the support people required, their individual preferences and how their needs should be met.

Records did not consistently demonstrate that people, their relatives or representatives had been involved in assessments, care planning or review processes. One relative told us, "We were involved initially in the assessment but there has been no review that we are aware of. There is no written record or app I can use." Another person said, "As far as I’m aware I was not involved in the initial assessment of (family members) care."

Although staff were knowledgeable about the people they supported, governance systems had not identified or addressed concerns relating to assessment, review and care planning processes.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them.

Staff had completed training which enabled them to meet people’s needs.

People commented positively on staff knowledge. Comments included, “(Staff member) is very good at understanding (family member), and explains to me how to manage the hallucinations and behaviours (family member) experiences.” And “The staff seem trained and know (family member) very well. (Family member) is kept clean and routine care is very good.”

The registered manager told us they liaised with other healthcare professionals including community nurses, GP’s and Occupational Therapist’s (OT), however were unable to provide evidence demonstrating this.

The provider did not always work well across teams and services to support people.

People did not always experience effective coordination of care because information was not consistently recorded or shared in a way that supported continuity of support.

Care records and associated documentation did not always contain sufficient detail to ensure all staff had access to accurate and up to date information about people's needs and support requirements. Relatives told us they would like improved communication and more consistent information sharing to support people's care. One relative said, “I would like more shared information as (family member) has difficulty eating and drinking and it would be useful to have a record of what they have had. Staff have adapted foods to be offered little and often, as and when (family member) is interested, but it’s sometimes hard to know what (family member) has had and when.”

The provider had systems in place to support communication between staff. Staff were able to describe how concerns and changes in people's needs were escalated for review or referral to health and community professionals when required. Staff had access to care records, digital systems and on call arrangements which supported continuity of care. One staff member told us they could access the electronic care system and familiarise themselves with people's care needs, which they found helpful when supporting someone new or returning after a period of leave.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control.

People’s health and wellbeing needs were not always supported through clear and accurate care planning. Care plans and risk assessments sometimes contained limited information and were inconsistent or lacked sufficient detail to guide staff in how to support people safely and effectively.

Despite these recording concerns, staff we spoke with knew people well and demonstrated a good understanding of their individual health needs, preferences and routines. Staff were able to explain how they monitored people’s wellbeing, recognised changes in their health and sought advice from healthcare professionals when required.

Staff described how concerns about people’s health were escalated and referrals made when needs changed.

The lack of detailed and person centred care plans and risk assessments meant there was not always clear guidance available to ensure a consistent approach to supporting people’s health and wellbeing.

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 the expectations of people themselves.

People were not always supported by effective systems to monitor and improve outcomes. The provider had not established consistent processes to review people's care, seek feedback or evaluate whether care and support continued to meet people's needs and achieve positive outcomes.

The provider had not routinely sought feedback from people, relatives or other stakeholders through surveys, questionnaires or structured opportunities to comment on the quality of care provided. This limited the provider's ability to understand people's experiences and use feedback to drive improvement.

One relative told us, “We have no regular contact or updates. I would really like more updates and shared information as well as an emergency out of hours number.”

Although staff knew people well and could describe their needs and preferences, systems to monitor outcomes, review care effectiveness and identify learning and improvement were not sufficiently robust.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff had completed Mental Capacity Act training and demonstrated a good understanding of how to apply this in practice to support people to make informed decisions and maintain control over their daily lives. Staff described how they would provide information in a way people could understand, allow time for decision making and support people to express their wishes and preferences. They understood the importance of gaining consent before providing care and treatment and respecting people's right to refuse support.

Care planning and assessment processes included consideration of consent and decision making. Relevant legal documentation, including Lasting Power of Attorney arrangements where applicable, was obtained during the assessment process to help ensure decisions were made in line with people's wishes and legal rights.

However, records did not always clearly demonstrate that consent had been obtained and recorded appropriately. In some cases, consent sections had been left blank. In other records, consent forms had been signed by the provider rather than the person receiving care or their authorised representative. For example, for those people who were assumed to have mental capacity to make decisions records were not always completed or signed