Das Care Limited

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.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 sure people’s care and treatment were effective.

At our previous assessment, we identified concerns about the provider's recording of people’s care reviews. We found similar concerns during this assessment.

People’s needs were assessed before care started and assessments informed care planning and risk management. Care plans included information about people’s health, wellbeing, communication needs and daily support requirements. Staff used communication tools and adapted approaches, including simple language, visual prompts and family involvement where appropriate, to support people to participate in assessments, reviews and decisions about their care.

However, records were not always robust or consistent. Some assessments contained contradictory information and there were examples where care planning did not fully reflect people's needs or desired outcomes. For example, 1 person's moving and handling care plan did not explain what they wanted to achieve through the support provided. Other records reviewed showed inaccuracies within clinical assessment tools, including inconsistent Waterlow scoring and incomplete nutritional risk information. Risk assessment records were broadly present, but not robust or complete.

Care plans indicated reviews had taken place, but records did not always clearly show when reviews were completed, what had been discussed or what changes had been made. Although the provider told us electronic reminders were issued every 6 months and records could be updated sooner if people’s needs changed, documentation did not consistently demonstrate this. Audit findings and care plan records were not always consistent. For example, an audit identified changes were needed to 1 person’s showering independence, however this was not clearly reflected within their care plan.

Review dates were also unclear, with care records and management meeting minutes showing conflicting information about when reviews had taken place. This reduced assurance that care plan reviews were accurately recorded and up to date.

However, a senior member of care staff confirmed they worked with staff, families and healthcare professionals during care reviews to make sure care remains appropriate and person-centred.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive andconsistent, or that they met both clinical expectations and the expectations of people themselves.

At our previous assessment, we identified shortfalls in the provider’s systems for monitoring people’s care and treatment. We found similar concerns during this assessment.

Systems for monitoring outcomes were not always effective. Information about people's outcomes was limited throughout care records and there was little evidence of measurable outcome tracking. Daily notes often focused on tasks completed rather than the impact of care on people's wellbeing, independence or health outcomes. Records did not consistently demonstrate how care and support had improved or maintained outcomes for people, including areas such as mobility, independence or oral healthcare. In addition, records did not always evidence reviews of health conditions such as diabetes, depression or blood pressure monitoring where relevant.

Records we reviewed showed staff monitored people's wellbeing through daily records and observations.

The provider gathered feedback from people using the service through surveys and spot checks of staff practice. However, it was unclear how feedback from spot checks was recorded or used, and surveys were limited to multiple-choice responses, reducing opportunities for more detailed comments.

During our feedback call, the provider told us staff had been reminded about record keeping expectations, and a further meeting had been arranged to improve the quality of daily recording.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.