Nottingham DCA

On this page

• 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 requires improvement. At this assessment the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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. Although care plans did not always accurately reflect these actions we observed staff supporting people in a person-centred way. Staff understood the importance of providing person-centred care and were able to describe what this meant to them. Staff sought people’s permission prior to undertaking any action and we saw multiple examples of staff spending time with people to discuss their options and choices in a way that was meaningful to them.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. As described in effective people were not always supported to attend routine check-up appointments as per the guidance in their care plan and additional health screening had not always been considered. However, people and relatives consistently told us their care was supportive of choice and continuity. One relative said “Staff really know and understand [name] and have done wonders for them. The provider is also giving more training on specific mental health conditions, and this is really helping people and staff, I cannot fault them.”

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Some documentation was provided in easy read format for people where appropriate, such as tenancy agreements, but this was not done consistently to support people’s understanding and empower them with decision making and choices. However, we did not see any evidence of care plans being formatted in this way to support people’s understanding. Relatives we spoke with confirmed that they had been included in the care planning process but had not seen their loved ones care plan and did not know whether this reflected their needs.

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. We saw evidence of regular staff and resident meetings where people were encouraged to give feedback and make suggestions. Everyone we spoke with told us they knew how to make a complaint and would feel confident to do so if the need arose.

The provider made sure that people could access the care, support and treatment they needed when they needed it. Professionals we spoke with told us that the provider and staff were knowledgeable about people and their condition and were responsive to any advice or guidance given. One professional said, “I feel that my views have been listened too [by staff] and we have been able to resolve any differences of opinion well in how best to support people professionally and ensuring people get person-centred care quickly in line with their needs.”

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Everyone we spoke with told us the culture of the service was open and inclusive. People gave examples of staff supporting them to overcome barriers through technology aids such as smart communication devices, and to physical barriers such as moving and transferring equipment. Other people described emotional support which broke down barriers in relation to mental health and anxiety. Staff told us they were supported by the provider and gave examples of reasonable adjustment to enable them to return to work quickly and safely following periods of sickness.

At the time of assessment no one was in receipt of end-of-life care. Care plans contained information of how people wished to be supported in the event of their condition deteriorating and who they wished to be contacted. However, in other aspects of planning for the future such as goals, aspirations or plans to transition to independent living, care plan lacked this person-centred detail. Care plans focused on daily goals that were task orientated and not person- centred to people. We discussed this with the registered manager who acknowledged this documentation was lacking and they put an action plan in place to review and update care plans accordingly.