DDLTAC(UK) - LONDON

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 to requires improvement.

This meant the provider did not ensure people’s needs would always be met.

This service scored 54 (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 it clear that people were at the centre of their care and support choices and did not always demonstrate they worked in partnership with people to decide how to respond to any relevant changes in people’s needs.

The person’s assessments and plans were not sufficiently person-centred. The information in them was vague and did not describe their needs, presentations and preferences in a sufficiently individually detailed, informative and instructive way.

The provider reviewed the person’s care plan annually. However, the person’s most recent care plan review stated there had been changes in the person’s eating habits but did not say when that had happened. This meant it was not clear whether the person’s care plan should have been reviewed sooner. In addition, the person’s care plan review was not dated and signed by the person, and there was no explanation for why they had not signed it. This meant it was not clear whether the provider had involved the person in their care plan review.

However, the provider and staff knew the person well and the person received their care and support in line with their needs and preferences.

The provider understood the health and care needs of people, so care was joined-up, flexible and supported choice and continuity.

The person received continuity of care from the same core care staff who knew the person’s history, needs, behaviours and preferences well.

The provider did not always sufficiently record and plan for people’s individual communication needs and did not always provide people with up-to-date information.

The registered manager was unaware of the Accessible Information Standard (AIS) and its 5 principles and the person’s assessments and plans did not include sufficient information about their individual communication needs and preferences. The AIS a legal rule in the UK requiring all NHS and publicly funded adult social care services to provide information in accessible formats.

The person was not provided with the scheduled times of their care calls. The person told us, “I wasn't given the times of my [care] calls.”

However, the provider and staff knew the person well and made sure information was tailored to their individual communication needs and provided in ways they could understand.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support.

The provider had a complaint policy and procedures in place. However, the policy did not include a timeframe for dealing with complaints. In addition, it stated formal complaints should in the first instance be sent in writing to the member of staff involved instead of the management of the service.

The provider carried out feedback surveys with the person and formulated an action plan in response to their feedback. However, not all the feedback surveys were dated, the provider’s action plan was not dated and there was no evidence the actions had been carried out.

The provider carried out staff surveys. However, the surveys were not dated and there was no evidence all staff had been given surveys, as we received evidence of only 2 staff responses, and both were not dated and only 1 included a job title.

This meant we could not be assured how often the provider carried out feedback surveys, whether everyone was given the opportunity to respond and whether actions arising from feedback were carried out. Therefore, it was not clear whether the provider’s systems and processes for listening to and involving people were effective.

The provider made sure that people could access the care and support they needed when they needed it.

The person and staff could contact the registered manager out of office hours using an emergency telephone number.

However, the provider did not have an on-call rota in place, and the registered manager was always the member of staff on call. This meant there was potential for the registered manager to become overworked, which could potentially have a negative impact on the management and provision of the service.

A member of staff told us, “The registered manager is always on call out-of-hours. Service users also call her anytime. Her personal phone is always on.” Another staff member said, “The registered manager is always on call out-of-hours.”

Staff and leaders did not always actively listen 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.

Not all staff, including the registered manager, had completed EDHR (Equality, Diversity and Human Rights) training and the person’s assessments and plans did not include specific and person-centred information regarding their diversity and human rights.

However, the registered manager knew the 9 protected characteristics of the Equality Act 2010, and the provider and staff knew the person and their needs well. The person had experienced good outcomes. They had engaged with their care and support, had taken their medicines and had maintained good physical and mental health, which was an improvement compared to past experiences before they were supported by this service.

People were not 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.

The registered manager and staff had not completed end of life care training. This meant if a person wanted to make an end-of-life care plan or required end-of-life care, the provider and staff were not suitably trained and skilled to plan for it or provide it.

A member of staff told us, “I have not done end of life care training.” Another member of staff said, “I haven’t done end of life training with this company.”

At the time of our assessment, no one required end-of-life care.