DKM Healthcare 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

We assessed 2 quality statements in the effective key question and found areas of good practice and concern. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Though the assessment of these areas indicated areas of concern since the last inspection, our rating for the key question remains good. People’s needs and rights were supported. People’s care and treatment was effective due to receiving support from staff who were aware of people’s needs and preferences and respected these in a person-centred way. However, people’s care plans did not always contain clear information and reviews had not identified errors in the paperwork. Staff had good knowledge of the mental capacity act, including capacity and consent.

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.

People told us care was person-centred and all their needs were considered including communication needs and emotional wellbeing. One relative told us, "I meet regularly with the team to update care if needed. The personal, tailored care is excellent.”

The registered manager told us they carried out a detailed assessment with people and their families where appropriate before the person started care. They used information received from other professionals, for example referral information from the local authority, but always completed a face-to-face assessment. The assessment considered people's health, care, wellbeing, and communication, as well as their preferences. The registered manager said, "We discuss choices, whether the person prefers male or female staff, what time do they want to wake up/go to bed, we want to know how you want to be looked after, mobility support, cultural observation, the food they like."

The CQC had received feedback about prior concerns from partners about people’s care, which the provider had responded to. At the time of this assessment, we requested feedback from partners and did not receive any concerns.

Processes used to capture information regarding people's health, care, wellbeing, and communication needs had not always led to this information being documented appropriately in care plans. We found examples of very detailed information that had been recorded about people's care and communication needs but some documents lacked detail. Staff had access to documents on how to support people. People’s communication needs were recorded and understood by staff. This allowed staff to communicate with people and to have a clear understanding of the person’s needs.

People told us care and treatment was planned with them and included things that were important for them, for example, receiving enough fluid and nutrition in a way that met their needs, and what mattered to them, for example, how their home environment was arranged. One relative described their loved one’s care needs which included a specific way of providing nutrition which care staff were trained in and provided support with. Another relative described the importance of certain outings for their loved one who told us, "[Relative] loves to go out to the coffee shop, [name] has communication issues but the carers are very supportive."

Staff understood what was important for people and what mattered to them. Staff told us they encouraged people to be involved in planning their care, and supported people with nutrition and hydration, and monitored people's weight. They did this in line with guidance from professionals when required. One staff member told us, "We work alongside other professionals such as the speech and language team, dietitian, GP and social workers."

We found that people's care plans did not always contain clear information about what was important for people and what mattered to them. We found one person's care plan contained information that was not relevant to their care. This was highlighted to the management team at the time of the assessment and the paperwork was removed. Another care plan we reviewed contained a lot of detailed information which included how to support the person with nutrition. While there was a difference in the quality of information in the care plans this had not impacted on people's care as staff knew people very well. The auditing of files had not identified issues with the care plans which was discussed with the management team at the time.

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.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

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.