District Healthcare Limited Also known as District Homecare

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

We assessed all of the quality statements within this key question. Our rating for this question is good. Most people told us they were involved in assessing their needs and were able to state their choices and preferences as to how their care and support was provided, however some people told us their visit times were not always suitable, the registered manager was aware of this and was working with the people to address these concerns. People and their relatives had confidence in the knowledge and skills of staff. People’s care and support was planned and delivered in line with current best practice and legislation. The registered manager and staff team wanted to continually improve the service to provide high-quality care. The service was working in line with the principles of the Mental Capacity Act 2005 (MCA).

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 they were given choice and consent was gained by staff when being supported with daily tasks. One person told us “They always treat me with respect and ask my consent before they do anything” and a relative told us “They treat him in a respectful manner and all seem really nice people”.

Staff told us the management team go out and see people using the service to ensure their care plan and risk assessments are clear and provide clear instructions for the staff on how to support the person. One staff member told us “We have one person who is a vegetarian and one who is lactose-free, that is always clear in the care plans”.

The registered manager had systems and processes in place to routinely review care plans and risk assessments. They also had systems and processes in place to assess new people using the service. We found care plans contained in-depth information about health needs and people’s likes and dislikes. However, we found some care plans had not been reviewed following the service processes. We also found some care plans and risk assessments which had been reviewed were not always relevant to the person’s current lifestyle or support. The registered manager was responsive to this feedback and implemented ways to address this and make improvements.

We received mixed feedback from people about receiving support with food. People told us staff were not aware of how to use some kitchen appliances. One person told us “Some staff know what they are doing with cooking however others do not”. Other people told us staff gave them choice and had no complaints.

Staff told us they knew where to find information about people’s nutrition and hydration within people’s electronic care plans. The registered manager told us about a scheme within the service where they would provide a trial hydration product to increase the fluid intake of a person whose intake may be poor. They would then signpost the person or relative to these products if it helped keep the person hydrated.

The registered manager was clear they would only provide support to people when they were confident they had the skills to meet their needs. They told us about the process when agreeing to care for a person and sourcing additional training tailored to the person’s needs before care started. Records we viewed were comprehensive in terms of initial care planning.

We spoke with people to learn more about their experience of using the service. People’s feedback did not highlight any concerns they had about the staff and service working together. One person told us they work well as a team and liked the carers that came to help.

We received positive feedback from staff about the management working with the staff. One person told us “Communication is fantastic from the office and you have so much support out in the community, (managers name) are fantastic and the nice thing about it, they come out and work with us”.

Feedback we received from partners told us the service engaged with commissioning initiatives such as dignity in care forums and complex case multidisciplinary team meetings.

Systems were in place to ensure staff were kept informed of changes within the service and with people’s needs. The registered manager told us about a trial where they had access to information regarding referrals and discharges and how relevant professionals involved in the person’s care were able to access copies of care plans and relevant documents. District Healthcare made sure the person involved in the trial only needed to tell their story once. This also supported the registered manager to consider people’s individuals’ needs, circumstances and ongoing care arrangements. The registered manager told us about occasions where access to information had allowed them to restart a person’s care package, prior to person coming out of hospital. This allowed the service to provide timely care and minimise risk of re-admission to the hospital.

One person told us about their experience with District Healthcare Ltd and how the support provided had allowed the person to reduce their future need of care and support. This person told us “The staff are angels, I am hoping I don’t need them soon, they have helped me and I am better now”.

The registered manager told us “People can do what they want to do but we can give them advice but we have to respect their choice”. The registered manager and staff told us how they supported people to attend medical appointments and maintain a healthy lifestyle.

Systems were in place for staff to source support for people when they became unwell. The management team had processes and oversight to make sure prompt responses were received from the relevant healthcare professionals to enable timely support.

People told us staff were well trained and they were satisfied in the outcomes of their experience mainly being supported to maintain their independence.

Staff spoke highly about their job and the company. One staff member said “Yes it is really good and the management team have been really supportive. If we have any concerns they are quick to follow-up with clients and families like if any GP needs calling they are really fast at doing that”.

The registered manager had processes in place to identify people’s desired outcomes and to ensure care and support enabled each person to live as they wanted to, taking into account the person’s unique skills, strengths and goals. Records in people’s care plans evidenced this. Staff recorded the care and support provided to the person and their observations about people’s health and well-being. The management team reviewed these records at regular intervals and used these to inform ongoing assessment and monitor people’s care and support. They also identified areas of improvement within the records and raised these with the staff team through supervision and team meetings.

We received mainly positive feedback from people about staff obtaining consent before carrying out support.

The registered manager told us how they obtained consent on a daily basis and how this was documented, they showed us this on their electronic care planning system. Staff told us about receiving Mental Capacity Act (MCA) training and how they would put this training into practice. One staff member told us “We do training on MCA and you assume nothing because every day is a different day for a client”. Records showed staff had received MCA training.

The registered manager had systems and processes in place to work within the principles of the MCA. Systems were in place to ensure mental capacity assessments had been completed with people and others involved in their care (where appropriate). People’s capacity and ability to consent were considered and documented throughout people’s care plans.