Archived: Nwando Domiciliary Care

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 Good. At this assessment the rating has remained Good.

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.

People had a support plan in place describing their individual care and support needs and including the delivery of support to be provided by staff at each visit. Where people were referred to the service for reablement each person had a support plan in place. This focused on supporting people’s recovery and self-confidence building. A review of people’s reablement package was completed to monitor their progress, with a review held at the end of the 6-week period or sooner if the person had reached their goals. Most people’s goals related to them wishing to retain their previous abilities and/or achieve a good level of independence. Where appropriate people had additional support from external healthcare professionals, for example, occupational therapist and/or physiotherapist to aid their reablement.

A member of staff told us, “I usually have enough time to go through the care plan before delivering care. The care plans are detailed and easy to understand, outlining people’s preferences, medical needs, and personal routines.”

The provider demonstrated an understanding of the diverse health and care needs of individuals and the local community, so care was joined up. However, improvements were required to ensure staff worked to tailor support in line with these needs. As already recorded within this assessment report, not all staff stayed for the scheduled time agreed with the service and call visit times were repeatedly raised as inconsistent. Since our assessment, the provider has introduced smaller focused areas for staff to work, so as to improve consistency.

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

The provider stated information could be provided in an easy read and pictorial format to enable people with a disability and/or living with dementia to understand the information and to comply with the requirements of the Accessible Information Standard.

Support plans had communication records in place to guide staff on how best to communicate with the people they supported. Minor concerns were raised about some staff members ability to effectively converse and communicate with them. A person using the service told us, “English is not my carers’ first language.” They explained that cultural differences relating to their dietary needs were not always understood easily by staff, but this did not concern them. The provider confirmed where staff’s first language was not English, foreign language classes were promoted.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Improvements were required to ensure issues raised were addressed in the longer term and to a satisfactory outcome.

People and relatives told us the service had an open and transparent culture whereby people using the domiciliary care service and those acting on their behalf felt confident about speaking up and raising any concerns. Comments from people using the service and relatives included, “They [Nwando Domiciliary Care] told me if I ever have a concern or a complaint to ring the office, they will deal with it. So far, we have had no concerns” and “I am happy to raise concerns and complaints.” However, some relatives told us they were frustrated as having raised a concern, particularly relating to staff call visiting times, raising the issue had not always improved the situation in the longer term.

The provider and manager responsible for quality assurance told us they encouraged people who used the service, relatives and staff to share feedback about the quality of the service provided, and what it was like to work at Nwando Domiciliary Care service. Quality assurance surveys had been forwarded to individuals, inviting them to provide feedback and suggestions for improvement. These were last completed in 2025. Where areas for improvement were cited, there was an action plan completed to indicate how these were to be addressed.

The provider made sure that people could access the care and support they needed when they needed it. The provider understood how to access specialist support should this be required and developed links with local health and social care teams.

Discussions with people using the service and those acting on their behalf implied they had not experienced discrimination or inequality. Care records demonstrated people were able to access services, including a range of external healthcare services and professionals when needed.

There was no evidence to suggest people experienced delays in healthcare provision.

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 service understood the impact inequality could pose on people using the service. The provider was flexible with their approach and support to ensure people had an experience which was fair and just. The staff worked with other professionals to make sure they understood and met people’s individual needs.

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.

Where people were assessed as being at the end of their life, they had an end-of-life care plan in place. Information recorded their decisions about their preferences for end-of-life care. For example, there was guidance in place for staff detailing how the person wished to be cared for so as to receive a comfortable, dignified and pain-free death. The support plan for 1 person using the service stated they wished to remain in their own home, to have gender specific staff provide care and support, and to be able to remain in their own bed rather than a specialist profiling bed. The support plan confirmed that the associated risks relating to the latter had been explained. Other risks had been identified and assessed. The support plan confirmed the involvement of external healthcare professionals, such as, the palliative care team from the local hospice and district nurse services.

Another person’s end-of-life support plan was as sufficiently detailed and confirmed the involvement of the local Speech and Language Therapy [SALT] team, including specific eating and drinking instructions and how their medication should be administered to ensure their safety and wellbeing.