Dignity Direct Homecare Limited

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to inadequate. This meant there were widespread and significant shortfalls in leadership. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was in breach of legal regulation 17 in relation to good governance. The provider did not have an effective oversight of the service.

This service scored 36 (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 had not always developed an inclusive culture at the service. People and their relatives gave us mixed feedback about how the service was run and the support they received from the registered manager and care workers, further details described under safe, effective, caring and responsive sections. This meant the provider’s direction and culture of the service had not always identified the barriers that people using the service were experiencing.

Leaders did not always have the skills, knowledge to lead effectively. The provider failed to make improvements and were in repeat breaches about person-centred care, need for consent, staffing, good governance, and a new breach about dignity and respect. We asked the registered manager about some senior staff who coordinated the previous assessment, as they were not around at this assessment. In response, the registered manager said, “Got rid of them.” This meant people continued to remain at risk of receiving unsafe care and treatment and support.

During our assessment, we found the provider (Also the registered manager) to be defensive in nature and not open to the assessment process. Where feedback was provided regarding people’s experiences, the provider failed to provide assurances that people’s experiences would improve.

Notwithstanding the above, there was a clear management structure at the service. Care workers were aware of the roles of the office management team. The service had an on-call system to make sure care workers had support outside of office working hours and they were approachable.

The provider had systems and process for people and their relatives, and care workers to speak up and share their concerns. Care workers were aware of these and told us they felt confident speaking with the office staff if required. However, people and their relatives feedback was shared with the provider, and they were dismissive.

The provider had not valued diversity in their workforce. Care workers were not employed from a range of cultural backgrounds to match with people who used services, but they were from a specific cultural and faith background, and there had been a big language barrier among care workers and people and their relatives, including concerns about care worker delivering personal care with full face cover causing discomfort to people. One relative said, “The organisation should instruct carers to speak in English and to recruit people who had adequate competency in English language.”

At our last assessment in September 2024 the provider had failed to operate effective quality assurance process. This was a breach of Regulation 17. At this assessment, we found the provider had remained in breach of Regulation 17.

The provider did not have an effective oversight of the service. We found that the provider had carried out spot checks, gathered feedback from people and their relatives, supported care workers through regular supervisions, and carried out regular audits. However, we found the systems in place to monitor and assess the quality and safety of the service provided had failed to identify the concerns we found at this assessment.

Office management system and process to respond to service user’s concerns was not effective. During the assessment, our 2 Experts by Experience spoke with 21 service users and their relatives about their experience with office staff. We received mixed response from people and their relatives about the management of the service.

Systems were not in place to ensure that the provider acted in accordance with the requirements of the Mental Capacity Act 2005 (MCA) and associated code of practice before delivering a regulated activity to service users.

Care workers did not understand what was safeguarding, whistleblowing, what was meant by consent, what to do following an incident and accident, and they did not remember what training they had received; therefore we were not assured the training was effective.

We found failings with regard to late calls, short calls, double handed calls, calls logged in at 2 locations simultaneously, calls were manually logged, unlogged calls, no travel time between calls, and call rota. Most of these issues were also represented in the feedback we gathered from people and their relatives.

The scheduling of the home visits rota was flawed, as some home visits were scheduled before the completion of the previous call.

Care workers had written very briefly about what they had done and observed when providing care to people, however most care workers left the notes section blank in the care log. Therefore, we were not assured if all planned care tasks were carried out in line with service user agreed care plans.

Some care workers were not aware of PRN (as required) protocols to safely administer medicines to service users.

The provider had not valued diversity in their workforce and there had been a big language barrier among care workers, people and their relatives.

The provider worked in partnership with local authority colleagues and a range of healthcare professionals.

At our last assessment in September 2024 we found the provider was in breach of 6 regulations in relation to safe care and treatment, effective staffing, person centred care, need for consent, good governance and fit and proper persons employed. As a result, we served warning notices (WN) for regulation 17 (Good governance) regulation 12 (Safe care and treatment) and for regulation 18 (Staffing). We further issued requirement notices for regulation 11 (Need for consent) and regulation 9 (Person-centred care).

The provider did not always focus on continuous learning and improvement across the organisation. At this assessment, we found the provider had made improvements with regard to regulation 12 safe care and treatment. However, the provider failed to make improvements and were in repeat breaches for regulation 9 (Person-centred care) regulation 11 (Need for consent). Also, they failed to meet the WNs for regulation 18 and regulation 17. This meant people continued to remain at risk of receiving unsafe care and treatment and support. In addition they were in breach for regulation 10 (Dignity and respect).