Caring with Dignity 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.

This is the first assessment for this registered service. This key question has been rated Good.

This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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. During the assessment, some care plans were found to contain inaccuracies, including incorrect mobility information and duplicated medicine entries. While these issues did not indicate a widespread failure of person-centred care, they demonstrated documentation did not always consistently reflect people’s current needs. In addition, some relatives reported concerns regarding continuity and communication, indicating partnership working was not always experienced positively.

Despite these shortfalls, the provider generally ensured people were involved in decisions about their care and worked in partnership with them to respond to changes in need. People experienced personalised support, with examples of care being adapted to reflect individual circumstances. Relatives confirmed staff asked directly about people’s requirements and consulted families when clinical changes occurred, helping to shape care in line with people’s needs and preferences. There was evidence of reasonable adjustments; for example, staff supported a person to move downstairs following a review of needs, demonstrating responsiveness to changing circumstances. Staff advised changes were communicated through an internal messaging platform and recorded in care notes to promote shared understanding among the team.

The provider demonstrated an understanding of the diverse health and care needs of people using the service, supporting joined-up, flexible care that promoted choice and continuity.

Relatives generally felt the service understood individual needs and responded proactively. Examples included staff organising prescriptions, identifying early signs of infection, adjusting routines, and supporting hospital discharge. Families described effective coordination with external professionals and valued staff acting as, “Ears and eyes” when they lived at a distance, helping to maintain continuity across services.

While some concerns were raised about continuity of carers, many relatives expressed confidence in the reliability of the service. There were examples of people receiving regular carers who arrived on time, stayed for the agreed duration, and communicated if delayed. Staff and leaders used established communication systems, including an internal messaging platform, to share updates and ensure changes in needs were communicated across the team.

Overall, care was generally coordinated and consistent, with systems in place to support continuity and integrated working.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Staff used written communication for individuals with hearing impairments, enabling them to participate in conversations and make informed choices. For example, 1 staff member described writing down messages on a white board for a person with significant hearing difficulties to support effective communication. Staff also supported people with practical aspects of communication, including sourcing and changing hearing aid batteries to ensure equipment remained functional. Relatives confirmed staff maintained regular contact, providing updates by telephone and sharing information about any changes or concerns.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. People and relatives generally feel staff listened to them and involved them in conversations about care. Staff gathered people’s preferences directly and checked with families whenever changes in clinical needs arose, helping ensure people remained involved in decisions about their care and support. Relatives shared examples of responsive communication, describing how staff kept them updated, and stepped in during stressful situations.

The service also had structured systems to ensure people could raise concerns and be heard, including a complaints policy that emphasised openness, transparency and the right for people to have their concerns fully investigated within clear timeframes. The complaints log recorded actions taken and outcomes for each concern raised, showing that feedback is acknowledged and responded to. Staff confirmed they would support people or relatives to escalate concerns by providing management contact details and explaining how to make a complaint when needed. While 1 relative felt they had not always been asked for feedback, most reported positive, open communication, and the service had clear processes to capture, investigate and act on people’s views.

The provider made sure people could access the care, support and treatment they needed when they needed it. People were supported to access care in an equitable and inclusive way, with reasonable adjustments made to ensure their specific needs did not prevent them from receiving support. There was evidence reasonable adjustments were made to support staff to carry out their roles. For example, adjustments to equipment and tasks were made to accommodate individual needs, ensuring staff could perform their duties while removing barriers to participation.

Leaders helped maintain fair access to care by working closely with staff, people and families to identify needs early and ensure appropriate support was in place. Staff received training in equality and diversity, and reported they feel supported and treated fairly, with no concerns about discrimination within the service.

Staff and leaders listened to information about people who may experience inequality and adapted care, support and treatment to meet individual needs.

People generally experienced fair and respectful treatment, with no concerns raised about discrimination within the service. Staff described treating everyone equally, and relatives commented positively on the caring and supportive culture, describing carers as, “Kind,” “Amazing” and “Like family”. Staff supported people to overcome individual barriers and participate in daily routines, helping ensure equitable access to care. No one reported experiencing discrimination, and staff confirmed they had no concerns about how they or others were treated at work.

Leaders and staff demonstrated awareness of potential barriers and took steps to support equitable outcomes. Staff understood the concept of discrimination and felt prepared to act if required, even though advocacy had not often been needed.

People had not always been supported to plan for important life changes, which limited the time available to make informed decisions about their future, including end of life care.

People had some opportunities to express their wishes and preferences, which were respected and recorded in care plans. However, there was limited evidence of structured future-focused planning, including Do Not Attempt Cardiopulmonary Resuscitation decisions, advanced care planning, or funeral arrangements. While these discussions may have taken place, they were not consistently documented in the records reviewed, suggesting planning for longer-term goals and end of life preferences was not fully embedded in routine practice. Staff reported completing online training in end-of-life care, which was confirmed by training records, indicating awareness of the importance of these discussions even though formal systems to document them were not found in people’s records.