Dignity Direct Homecare Limited

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• 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.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation 11 in relation to staffing. The provider did not always work within the principles of the Mental Capacity Act (MCA) 2005.

This service scored 62 (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’s care was effective by assessing and reviewing their care needs. One person told us, “Yes, a senior staff member and carer came from Dignity Direct to do an assessment. They asked about my background, interests and health needs. They (Staff) asked us what care was needed and wrote it all down.” The assessments looked at people’s medical conditions, physical and mental health, mobility, nutrition, choice, and people’s home environment. Where appropriate, people and their relatives were involved in this assessment. This information was used as a basis for developing personalised care plans.

The provider did not always plan and deliver people’s care and treatment. Where required office staff sought support from GP, district nurse, Speech and Language Therapists (SALT) and occupational therapist (OT). Care plans contained guidance for care workers to follow. Care workers told us how they supported people to eat and drink to meet their needs.

However, we received mixed feedback from people. One relative told us, “My (Loved one) doesn’t get their food and then my (Loved one) is hungry. I don’t trust carers around my (Loved one) one day it will all go wrong.” Another relative said, “Yes, they (Care workers) make porridge and feed my loved one. I do most of [their] other food. The carers are respectful of our cultural needs.”

The provider worked well with external health and social care professionals to support people for example, commissioners, GP and district nurse. They held meetings with care workers to discuss areas such as any changes in people’s needs and coordination with relatives, health and social care professionals as appropriate.

The provider supported people to manage their health and wellbeing if required. People’s healthcare needs were recorded in their care plans along with any support required from care workers in relation to their needs. People’s care records reflected contact details of healthcare professionals for example, speech and language therapist, district, GP, OT and hospitals.

The provider monitored people’s health and wellbeing to improve it. Care workers told us they would inform relatives and notify the office staff if people’s needs changed and if they required the input of an external professional for example, district nurse, GP, speech and language therapists (SALT), and occupational therapist.

At our last assessment in September 2024 the provider had failed to work within the principles of the MCA. This was a breach of Regulation 11. At this assessment, we found the provider had remained in breach of Regulation 11.

The provider did not always work within the principles of the Mental Capacity Act (MCA) 2005. We found 10 people who lacked the mental capacity to make informed decisions or give consent, the provider failed to act in accordance with the requirements of the MCA and associated code of practice before delivering a regulated activity to them. For example, a person’s mental capacity assessment was carried out on 28 March 2025 by a member of staff and concluded as lacked capacity. However, the assessment further noted that the best interest decision (BID) was not required. We found that a relative had signed the consent form, but there was no BID or a legal power of attorney (LPA) in this matter. Another person’s capacity assessment was carried out on 6 July 2025 by a staff member and concluded as lacked capacity. However, the assessment further noted that the best interest decision (BID) was not required. There was no LPA or BID, but a relative had signed the consent form. This demonstrated the provider’s systems for assessing people’s capacity and best interest decisions were not robust.

Notwithstanding the above, people told us they were consented before staff supported them. For example, a person told us, “They (Care worker) don’t need to ask consent. We know each other. But they will ask if they are unsure. I’m very vocal and not shy to ask how I want things done. They do what I tell them and meet my needs.” A relative said, “They (Care workers) involve my (Loved one) in their care, like washing face and to keep moving. They talk through what they are doing. If my loved one didn’t want to do something, then they wouldn’t pressurise.”