4 May 2017
During a routine inspection
Hertfordshire Domiciliary Care Services provides personal care and support to people living in their own homes and supported living accommodation. There were 48 people using the service on the day of our inspection. However, only 11 of those people were receiving a regulated activity from the service. A regulated activity is registered under the Health and Social Care Act and this service is registered for the Regulated Activity of Personal Care.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. In this instance the registered manager was also the provider.
The service had experienced some staffing difficulties and had changed management structure over the last two years. As a result people who used the service had not always experienced care and support which was effective and personalised.
People told us they were overall happy with the service, the only complaint they had was about not knowing which staff member would turn up and when they would receive the care and support they needed. People told us this had no effect on their safety; however they could only plan their days after staff visited them.
The registered manager and the provider recognised that the service they had provided was not always responsive and of good quality therefore they were not taking on care and support for additional people at this time. They had implemented new recruitment processes which were more effective and since November 2016 they managed to recruit a high number of permanent staff, however there were still vacancies in staffing hours.
Staff we spoke with were knowledgeable about people`s needs and the risks involved in people`s daily living, however people`s care plans were not always reflective of their current needs. Although staff were trained in safe administration of medicines they were not always following best practice guidance when administering people`s medicines.
Staff felt that they had received better support from the management team in the past couple of months than before. They told us things had slightly improved and staffing was better; however last minute sickness or absence still caused stress and put pressure on them to cover for these.
There were systems in place to monitor the quality of the service and additional systems were being developed to help ensure the support provided was consistent. This included implementing a system where time specific calls were marked on staff`s rotas to ensure visit times were on time and for the full duration of the time allocated to people.
People told us they felt safe and trusted the staff who offered them care and support. Staff were knowledgeable about safeguarding procedures and how to report their concerns. Staff knew people well and treated them with dignity and respect.
People told us that they were supported to make their own decisions and choices which staff respected. They told us they had discussions with their key worker about their care plans and their needs. The provider had started organising meetings with people to gather their views on what they liked and disliked about the service and how to improve.