Daffodil Care Ltd

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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.

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

This meant people’s needs were not always met.

This service scored 57 (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.

People were not always fully involved in planning and reviewing their care and support. Care plans and associated records were not always clear, accurate or updated to reflect people's current needs, preferences and goals. This meant staff could not always rely on records to provide consistent, personalised support.

Feedback from people and relatives about their involvement in care planning was mixed. Some people told us they felt listened to and involved in decisions about their care. However, others described limited involvement and communication from the provider. One relative told us, "We don’t have much to do with the agency and office as we have full oversight of the care. We have raised the issue of new staff needing to shadow as they don’t know (family members) care. This has resulted in us declining care visits from new staff."

Relatives also raised concerns about access to information and communication regarding care arrangements and changes. One relative told us, "There is very much a lack of information sharing in written form." Another said, ”There is no written record or app I can use.”

People's views, preferences and changing needs were not always clearly reflected in care records, and communication with relatives was not always sufficient to ensure they felt informed and involved in decisions about care and support.

There were some shortfalls in how the provider understood the diverse health and care needs of people, so care was not always joined-up, flexible or supportive of choice and continuity.

Consistency of care staff was important to people and relatives and feedback about this was mixed. Some people spoke positively about receiving support from regular staff who knew them well and understood their needs. One relative told us, “Staff have been coming for 2 years now. It is the same two carers, and they absolutely do keep (family member) safe.” Another relative described a positive relationship with a regular carer and said, "(Family member) has the same carer who has got to know them very well. (Staff) knows exactly how to manage (family member) mobility safely and what works best. They are punctual and reliable, and we feel (family member) is safe with the carer."

However, other feedback highlighted inconsistencies in staffing arrangements and communication. One relative told us, "There are some rota swaps between the two main staff which is difficult to know who is there and when." Some people said they were not always informed when a different member of staff would be providing their care.

As previously mentioned, care plans and risk assessments did not always contain sufficient information to enable staff to fully understand people's health needs, associated risks and the support required. Information was sometimes limited, generic or lacked clear guidance for staff on how to respond to people's individual needs.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

We received mixed feedback from people and their relatives about access to information and care records. Some people and their relatives had access to the provider's electronic care planning system and were able to view information about their care. However, others told us they had not been informed how to access the electronic system in place. This meant people and those important to them were not always able to access information about their care in a consistent way.

Care plans contained information about people's communication needs, which helped staff understand how to communicate effectively with people.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

People and relatives told us they knew how to raise concerns and would feel comfortable speaking to care staff if they needed to. However, feedback we received indicated people did not always feel well connected to the management team or have regular opportunities to share their views about the service.

People also described limited opportunity to be involved in reviews of the care they received. One person told us, “There hasn’t been any review, feedback opportunities or questionnaires". Another relative said, “We were involved in the initial care plan assessment but there has been no review following this that we are aware of."

These findings indicated the provider was not consistently seeking feedback from people and relatives or ensuring they remained involved in reviewing and developing care.

Staff told us they were confident in raising concerns and complaints and felt listened to by the management team.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

Staff understood people's individual needs and care plans contained information about communication, mobility and support requirements. However, feedback from people and relatives identified concerns about access to management support and out of hours assistance.

People were not always clear about who to contact if they needed support outside normal office hours. One person told us, "I've never had any contact with the office but if I need to, I think there is a number on the invoice that I receive each month." Another person said, "I would like an emergency out of hours number." These comments indicated people did not always have clear access to information about how to obtain support when concerns arose or when the office was closed. This may create barriers to accessing timely advice, support or reassurance when needed.

We fed this back to the provider who took action to address the comments raised.

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 an understanding of people's individual needs and circumstances and worked to provide care in a way that promoted equality, dignity and respect. People and their relatives told us they felt valued, listened to and supported by staff who were considerate of their needs and preferences.

Feedback from people and relatives was positive. One relative told us, "Staff are very accommodating and I know I can trust them and have complete piece of mind when I’m not there." Another person said, "The staff are kind and seem happy, they are respectful with (family member's) home and their privacy."

People described staff as caring, respectful and attentive. Feedback showed staff developed positive relationships with people and provided support in a way that promoted their wellbeing, privacy and independence. This helped people feel safe, valued and confident in the care they received.

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.

People were supported to plan for important life changes and future decisions. Where people had expressed wishes about their future care, this information was recorded and available to staff to help ensure care was provided in line with their preferences.

Records we reviewed contained clear information relating to Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions where these were in place. Documentation was appropriately completed, accessible and available to staff and relevant professionals when required. This helped ensure important decisions about people's care were known and respected.

Staff understood the importance of supporting people with dignity and compassion when discussing future care needs. Systems were in place to ensure significant information relating to people's wishes and decisions could be accessed when needed to support safe and person-centred care.