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 good practice and concern since the last inspection, our rating for the key question remains good. Peoples needs and rights were supported. People’s care and treatment were assessed but the information was not always clearly reflected in people’s care plans. However, people’s care was effective as staff knew them well and understood their health, care, well-being, and communication needs. Staff were aware people’s preferences and respected these in a person-centred way. People were aware of their rights around care and treatment. 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 described having an assessment of their care and support needs before care began and care reviews. One person told us, “The manager visited to assess my care needs before I started the care. They asked lots of questions from my family and me regarding my needs and well-being. I have an up-to-date care plan which is reviewed.”

Staff told us about the importance of assessing people’s needs and reviewing their health and well-being needs with them. Staff described creating care plans with people as well as alerting professionals if they noted a change in the person’s care needs. One staff member said, “Involving people in the development of the care plan empowers them, people are able to continue living the kind of life they were living before with a bit of help from the support staff.”

Processes used to capture information regarding people's health, care, well-being 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 but some information was not accurate which meant staff did not always have access to the correct information about people’s needs. 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’s care and treatment included what was important for them and what mattered to them. One relative described the care their relative living with dementia received, “[Relative] preferences and choices are always acknowledged. Because of their condition [relative] can no longer remember or understand English. They [staff] cook them soft, flavourful, cultural food.”

Staff understood the importance of considering people’s holistic needs which included their physical and mental wellbeing including good nutrition and hydration. One staff member told us about what they consider when supporting people, “What is important is to be treated like a human, being considered, being healthy, having positive relations with family, taken good care of, understood. l make sure they are eating a balanced diet, encourage them to eat when they don’t feel like it, sit with them during visits and chat about issues that interest them.” Staff understood how to work with external health and social care providers, to provide support in the most effective way.

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, which was in a different format, 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.