Delight Supported Living 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 newly 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 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. However, some language in care records was not in line with best practice, as it was outdated and did not always describe people in an empowering and person-centred way. For example, describing people as ‘bed-bound’. We raised this with the registered manager to review. People confirmed their needs were re-assessed regularly, and adjustments made after ‘spot-checks’ where they received a visit at home to discuss their support. A relative told us, “We had a big assessment to start with and now we have reviews of care because [person’s] needs have changed. The senior staff check in on the care workers too and make sure everything is alright; they are very good.”

The provider understood the diverse health and care needs of people and their local communities, but care provision was not always joined-up, flexible or delivered in a way to fully support choice and continuity. A relative told us, “[Staff] are very flexible. Sometimes I have had to take [person] to hospital on a Sunday and [staff member] will come early to help [person] get ready for the hospital, it really does help a lot.” Another relative said, “The agency is adaptable; we have had incidents where we have been stuck at the hospital and they are understanding and flexible.” Most people were satisfied with the continuity of care from the service, although we did receive some mixed feedback. For example, 1 person’s relative said, “We do have a small number of staff. [Name] is our number 1 and we have [them] most of the time. A new care worker or a substitute always comes with someone who knows us.” However, another relative said, “The carers are lovely but no consistency. They (the service) said they were trying to do their best and things have improved but only slightly.” Records showed continuity of care was a standing item which was regularly reviewed by the office team.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. People’s communication needs and preferences were clearly set out in care plans to support accessible information sharing. For example, some people communicated using electronic devices such as a tablet, rather than verbally with words. Care plans contained information to remind staff to be patient and allow people time to process information. For example, 1 person’s care plan stated, ‘Allow me time to respond without finishing for [me]. I get frustrated if you finish sentences for me.’ Staff could explain how they would support positive communication. A staff member said, “For people living with dementia or those who do not communicate verbally, I use patience, observation, body language, visual prompts and familiar routines to understand their preferences.” We received some feedback about communication barriers with staff who speak English as a second language, particularly for people with additional communication needs. A relative said, “I don’t think [person] understands the care workers and to be honest I struggle with them too, but they are very friendly.” We made the registered manager aware of this so support could be put in place as required.

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. There was a process in place for complaints, which were investigated, and a response and apology provided as required. People told us they knew how to raise any issues or concerns, and most people were satisfied with action taken from complaints made. A person said, “If I had any issues at all I would phone the office, but I would be lost without my lovely carers.” A relative said, “If I had a complaint, I would email the office.” There was also the opportunity to discuss any issues during regular monitoring visits which took place in the community. The service had also received a number of compliments.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People and their relatives told us the office was always contactable in case of any last-minute changes, updates or concerns. A relative said, “The office is always responsive to any messages.” We were informed messages could also be passed on by care workers if required. Another person’s relative said, “I can talk to any of them [care workers], all of the staff are very helpful.” There was also an on-call system, to ensure there was always someone available outside of business hours in case of an emergency. Records confirmed this was in place, supporting equitable access to support for people using the service.

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 told us they could inform management if a person’s needs changed, so a request could be made to ask for additional visits or time from the commissioning local authority. A staff member said, “If there are any changes or any client where l am spending more time than usual l always let my manager know so then they request for more time.” Staff could also tell us how they helped to promote wellbeing, and reduce the risks and barriers associated with social isolation. For example, 1 staff member told us, “We assisted [person] to register for local companionship and a support group. After a few weeks [person] was more confident and cheerful.”This included social support in the home environment. A relative said, “[Care workers] are punctual and always stay the full time; sometimes they will do an online jigsaw with [person] which [person] loves or a walk around the garden.”

People were not always 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. Basic information was recorded in care plans such as whether a person had a ‘Do not attempt cardiopulmonary resuscitation’ (DNACPR) in place. Staff received training in this area, and described supporting people at the end of their life with compassion and care, including emotional support for their family. However, care plans required further personalisation and information to show how people would like to be cared for holistically when very unwell or when reaching the end of their life.