Domiciliary Care Services (UK) 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 remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (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 were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People and family members told us they were fully involved in planning their care and making decisions about any required changes. A family member said, “Social Services suggested that we have an additional carer in the evening, and the company arranged this quickly.”

Staffs understanding of people’s cultural and communication needs, as well as a consistent team of staff, had enabled positive and supportive relationships between staff, people and their family members to be developed. This had a direct impact on people’s positive experience of the service.

Family members spoke of the positive relationships developed between staff and their relative and the impact this had on their wellbeing. A family member told us, “It is a great relief to have the carers. They laugh and joke with [relative], and cheer them up, just as they did with my grandmother twenty years ago.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People’s relatives confirmed they received the support and care they paid for, and that they received continuity of care from a core team of staff who were reliable, overseen by a management team who were committed to providing good quality care.

The provider and staff worked well with healthcare professionals, when required, to ensure people received continuity of care from everyone involved. This included support and contact with health care professionals.

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

People and family members spoke of effective communication, both in terms of staff being able to converse in their preferred language, but also with regards to good communication with office-based staff, including the registered manager.

People received a copy of the service user guide, which provided key information about the services provided by Domiciliary Care Services. For example, the referral and assessment process, aims and objective of the service, how to raise concerns including contact information and how the service was developed and shaped based on people’s feedback.

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.

Everyone we spoke with was knowledgeable as to how to raise a complaint and were equally confident any concerns would be responded to. Records showed concerns or complaints were listened and responded to in line with the provider’s policy and procedure. The outcomes of complaints were shared with staff to improve the quality of the service.

The provider sought people’s views and that of family members through surveys, visits to people’s home, and through telephone interviews. A person told us, “They send out a questionnaire every six months to get my feedback, and I get a visit by a supervisor every six months. And a family member said, “They send out a questionnaire occasionally to get feedback from us, and they also ring to find out how things are going.”

A report as to the findings of surveys was produced, which included any overall themes and trends identified, along with individual comments and feedback. The results of the most recent survey identified overall satisfaction in the service provided, which included positive comments about staff being friendly and respectful, and the support provided by office-based staff.

The registered manager produced newsletters, which provided people and family members with information about local services, including friendship and free activities within the local area. The newsletter also had information about the outcome of quality monitoring, including the outcome of surveys and any action being taken in response to people’s comments.

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

No concerns relating to people’s ability to access the service were found. There was no evidence to suggest anyone was disadvantaged or unable to receive support in a timely or consistent way. A person told us, “One of the advantages of with DCS is that they are at the end of the phone 24/7, and you can get hold of them easily. I know the manager and they are very approachable.”

People received care in line with their assessed needs. Care provision was arranged in a structured way to ensure staff could deliver care reliably and as planned. This meant people experienced equitable access to the service.

Staff’s availability to work was identified during the recruitment process and kept under review to ensure there were sufficient staff at the required times to meet the needs of people, to provide safe and effective service.

The provider had contingency plans in the event of an emergency. For example, staff absence, bad weather and medical emergencies to ensure care was never missed.

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.

The provider, management team and staff were alert to discrimination and inequality that could disadvantage different groups of people in accessing care, treatment and support. The provider recognised potential barriers including language, and in response supported people with staff who were able to speak with them in their preferred language and who understood their cultural needs.

The provider operated an on-call manager system to support staff where concerns were identified outside of normal office hours, providing advice, and contacting relevant professionals or family members where appropriate. An aspect of the on-call system was to attend people’s homes to support staff if required.

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.

At the time of our assessment staff were not providing support to anyone with end-of-life care. Staff had received training on end-of-life care. A member of staff said they had been involved in the care of a person with end-of-life care previously and spoke of how the package of care had been increased to provide support, and how they had worked collaboratively with nurses who administered prescribed medicines.

As part of the assessment and referral process, information was shared as to any known wishes expressed by the person regarding treatment in the event their health deteriorated, which had been recorded on a ReSPECT document or DNACPR (a document which records people’s advanced wishes should they stop breathing).

The registered manager and staff team had worked collaboratively with people’s G.P.’s, district nurses, palliative care team and other professionals as required.