Guild Care Domiciliary Care

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for this service since they reregistered. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

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.

Peoples’ needs, and choices, were assessed and took account of preferences for their support. Protected characteristics and diverse needs under the Equality Act formed part of this process. For example, people’s religious needs and preferences were captured. One relative said, “Yes they did. They did a good job on the care plan.”

People confirmed that they, and their relatives, were involved in their assessments of needs and reviews of their care. We saw evidence that care plans and risk assessments were continuously reviewed and updated when people’s needs changed. One relative said, “We discussed what we thought she needed and advised me.”

People received care, treatment and support that was evidence-based and in line with good practice standards. The provider’s systems ensured that staff are up to date with national legislation, evidence-based good practice and required standards.

The service demonstrated a structured and consistent approach to delivering evidence‑based care and treatment, with care plans and risk assessments clearly linked to recognised tools and current clinical guidance. For example, pressure area care was informed by Waterlow assessments, alongside planned interventions for ongoing skin monitoring and escalation of concerns. Nutritional risks were identified using Malnutrition Universal Screening Tool (MUST) scoring, with staff adapting support to promote adequate intake and mitigate identified risks, Where specialist input was required, this was embedded into care delivery; for instance, staff prepared food in accordance with Speech and Language Therapy (SALT) guidance for people at risk of dysphagia, ensuring meals were consistent with prescribed textures and promoting safer swallowing.

Care and treatment were further underpinned by comprehensive and regularly reviewed risk assessments. Moving and handling plans clearly reflected individuals’ assessed abilities and equipment needs, such as the use of rollators, grab rails and hoists, enabling people to maintain independence while reducing risk.

The service worked well across teams and services to support people. When people received care from a range of different staff, teams or services, it was co-ordinated effectively. Staff had access to the information they needed to appropriately assess, plan and deliver people’s care, treatment and support. One staff member said, “it is important for me being in the community to communicate with as much details I can with the office team to ensure all information is given correctly. Office team communicates well up to date with emails with any important information regarding any clients.”

The service demonstrated a strong and proactive approach to multidisciplinary working, which supported safe and coordinated care. Staff worked closely with a wide range of professionals, including SALT, occupational therapists, dementia specialists, district nurses and palliative care teams. Referrals were made promptly when concerns were identified, and care plans were updated to reflect specialist input. For example, the involvement of SALT in managing dysphagia led to safer swallowing practices and reduced the risk of choking. This showed that staff recognised changing needs and responded appropriately.

People were supported to manage their own health, care and wellbeing needs by staff who understood their needs and preferences.

The service actively supported people to maintain their health and wellbeing through timely referrals and coordinated care. Staff identified changes in people’s health, such as dental issues or swallowing difficulties, and took action to involve appropriate professionals.

Care was delivered in partnership with community health teams, including GPs, district nurses and specialist services, which supported early intervention and prevented deterioration. The service supported people to live healthier lives through proactive, personalised care planning and ongoing monitoring of health needs. Care records showed people were supported to maintain good nutrition and hydration in line with recognised guidance, including the use of MUST assessments and meal preparation to support adequate intake and reduce the risk of malnutrition.

Staff encouraged people to remain as independent as possible while supporting healthy routines, such as preparing meals of choice, promoting fluid intake and encouraging engagement in meaningful activities that supported physical and emotional wellbeing. Health conditions were clearly documented and regularly reviewed, with staff supporting people to manage long-term conditions in line with clinical advice and promoting early identification of deterioration.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent.

Quality assurance systems were in place to monitor people’s outcomes and support. Care plans, risk assessments were consistently reviewed and updated to reflect people’s changing needs and to ensure that safe and effective support continued. Training, effective communication and information sharing to and between staff meant they were clear on the standard of care expected from the provider. One relative said, “It’s a regular routine with the hoist and we work as a team. The hoist is checked and so is the hospital bed. I think the communication is very good, they are aware of my wife and keep her advised and talk her through everything. This helps keep her calm.”

People’s views and wishes were taken into account when their care was planned.

People supported by the service made their own decisions about their care and support. Initial assessments of care captured this. Assessments were carried out, and there was evidence of joint working with external partners, such as GPs and the local authority, when concerns about decision-making capacity arose. People were asked questions during assessments in line with MCA principles, which indicated that consent was considered in care planning.

Staff consistently demonstrated their awareness of people's right to make choices, and of the principles of the Mental Capacity Act (MCA). One staff member said, “capacity isn't a 'one word covers all' meaning to me so I would work with each person's level and include them in parts of their care as much as possible.” Another staff member said, “I would still offer choice whenever possible as I think it's important for people to feel they have some control over what they do.”