Dignity Direct Homecare Ltd - Sheffield

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 remained requires improvement. This meant people’s needs were not always met.

This service scored 50 (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. We could not be assured people received person centred support. We received mixed feedback from people and relatives about staff providing person centred support to them. A person said, “When the regular carer is on holiday then I get a cover. The cover doesn’t know the routine, and I don’t know who is coming. The covers come out of the blue and are not introduced to me. Staff change overs led to random carers coming over the summer. If they change then I’d like to know their names.” Whilst another person said, “I get on with the staff, depending on time they will sit and chat with me.” Care records contained conflicting information about people’s needs and preferences and some missing information. Care records contained information about people’s past history, cultural needs and people who were important to them. Staff told us how they met people’s individualised needs.

Information supporting continuity of care was not always sufficiently robust, as records were not consistently updated or cross-referenced when people’s needs changed. Although staff worked with external professionals, documentation did not always provide clear or detailed information about changes in support needs, increasing the risk of gaps in communication and coordinated care.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. At the time of our assessment no people had specific communication needs. People had detailed communication care plans in place, which contained guidance for staff about how to communicate with people. However, we found some information relating to a person’s speech which was not detailed in their care plan. Some people told us communication between the staff was challenging due to language barriers and this affected their quality of care.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result. We received mixed feedback from people and relatives about feeling listened to by the staff and management team. A relative said, “If I had an issue then I’d speak to the company or to the social services. Recently I contacted them about administrative errors and missed visits. I talked to more senior personnel and computer (data) input was not put in. It was resolved.” Whilst another person told us, “Sometimes carers didn’t turn up or timings were not right. I booked carers for two hours for some mornings and it was agreed. But no one would come. I got charged for a few of these. I phoned and e-mailed to complain and heard nothing back.” We found complaints were not always effectively monitored. Whilst some complaints were recorded and actioned, some complaints were not included in the logs, such as complaints received via the CQC. This meant the provider did not have effective oversight of the amount, themes and trends which were received. There was also a high number of complaints received relating to missed care tasks. People had been involved in providing feedback their care and support. This feedback was found to be overall positive, with people feeling happy about their care and support. Feedback was used to create a ‘you said, we did’ document, which evidenced what actions were taken in response to people’s feedback. For example, communication channels were recorded to have improved.

The provider made sure that people could access the care, support and treatment they needed when they needed it. People had access to external healthcare professionals, and we found staff had contacted emergency services where required. However, some improvements were required to ensure care records contained information about people’s current health input and how this was monitored and managed.

Staff and leaders did not always actively listened to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. Records evidenced staff supported people to do their shopping, attend appointments and with some activities. However, we received mixed feedback from people and relatives about their experiences of their care and support. 1 person said, “I haven’t been asked for my feedback. There is no newsletter either. The regular staff are good and sociable with me, but the new ones, less so.” A relative said, “I like the way they (staff) treat [name]. They are friendly and caring. There isn’t a lot to improve. I would score them 8/10.” The service recorded compliments they received, comments included ‘Carer is thoughtful and gives the service user encouragement when they need it’ and ‘The carer asks before helping and makes sure support is given in the way they prefer.’

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. At the time of our assessment no one was receiving support at the end of their life. Some improvements were required to ensure people’s care records contained person centred detail about their future goals and aspirations, and how these were being monitored and met.