Domiciliary Care Services (UK) Limited

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.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People and where appropriate, family members were involved in the assessment process, which in some instances followed the initial referral to the service by the funding authority. A family member told us, “A care plan was first drawn up by the hospital and then followed by DCS (Domiciliary Care Service), which lists the tasks to be done and a timetable.” Following the initial assessment, a follow-up assessment was undertaken, so as any changes to a person’s care needs could be made in a timely manner.

People, and family members told us care needs were regularly reviewed. A family member told us, “I was initially involved in drawing up the care plan. The manager has come in five of six times to review it.” People and family members told us staff provided the care and support as agreed.

Communication was a key element of the assessment process as the service supported people from diverse backgrounds, which meant needs around cultural diversity and language were essential to ensure people’s needs could be met.

Staff confirmed people’s care needs were regularly reviewed, and any changes were made to people’s care plans where required. Staff informed the registered manager of any changes in people’s care so as they could update the appropriate care records.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

The registered manager sought people’s views and that of their family members to ensure, where required, meals were provided in line with their needs and with consideration to people’s cultural needs. In most instances, family members prepared meals for their relatives, sometimes in advance. Staff then provided the level of assistance required to ensure people ate and drank.

People at risk of malnutrition or dehydration were monitored by staff to ensure they ate and drank sufficiently. A member of staff told us about a person they cared for. “We record how much [person] has eaten and drank. Any concerns we would report to a family member or the G.P.”

Care plans provided information as to people’s dietary requirements, which included cultural needs and where people needed a soft diet (foods that are tender, moist, and easy to chew or swallow). Any food allergies were recorded.

People who lived alone or had specific elements of care which required monitoring had an alert set up on the provider’s electronic monitoring system. If specific tasks were not completed by staff, the system generated and alert, monitored by the management team. This enabled the registered manager to check in with staff, and act if required, to ensure themselves that people’s care had been delivered in line with their care plan.

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.

People’s care records were accessible to both staff, people who use the service, and where appropriate their family members. A member of staff told us, “Care plans are clear and easily understood. I always read them when they’re changed by the manager, who reviews them regularly.” Staff supported people and family members to liaise with health care services and professionals where required.

The registered manager told us they maintained links with health and social care partners, and shared information relating to people’s health and well-being, including any changes in their assessed needs to ensure continuity of safe and effective care.

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.

Care plans supported people to maintain their independence by including information as to what person was able to do for themselves, and the level of support a person required by staff.

Most people were able to access support from health care services and professionals independently or with the support of family members, where required, staff liaised with other services and professionals. A family member told us, “Staff understand my [relatives] health condition.” Staff referred any concerns to a member of the management team, who would contact the relevant service.

The provider monitored people’s care and treatment to continuously improve it; however, the recording of care interventions and observations was not consistent in its detail. Outcomes for people were positive, which met people’s expectations.

Electronic care records detailed the care tasks to be undertaken by staff for each care visit, which were ticked once completed to evidence the support and care had been provided. Additional notes completed by staff, which provided further detail of care interventions and their observations were not completed consistently. This is an area for improvement, to support the reviewing of people’s needs and provide evidence as to any concerns noted or shared, in the event the quality of care was questioned. The registered manager informed us, whilst some staff were confident in using the electronic monitoring system, other staff continued to experience challenges. They told us additional support was being provided to support staff in this area. Staff would contact a manager by phone and report any concerns, which they would then record on the system.

People and family members spoke positively of the service they received, and of the positive impact. A person told us, “Due to a stroke, I wouldn’t be able to live on my own as I do now, without their support.” A family member told us, “The carers have had a very big impact on the family, the service has helped the family immensely. Having them has helped us a lot.”

Staff demonstrated a good knowledge of people’s health care needs and conditions and understood their role in monitoring any potential concerns, which included potential risk associated. For example, where people had a catheter, or where they were at risk of malnutrition or hydration.

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

The provider understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires, that, as far as possible, people make their own decisions and are helped to do so when needed. Where people lack mental capacity to make particular decisions, any made on their behalf must be in their best interests, and as least restrictive as possible.

People who received support and care had the capacity to make informed decisions, which meant assessments to determine people’s capacity had not been required. People’s records did include information if a person had a lasting power of attorney in place, in the event the person was unable to make an informed decision.

Decisions made by people as to whether family members were involved or informed in matters relating to their care, including information relating to health matters was respected. Ensuring people’s confidentiality was respected.