Background to this inspection
Updated
26 October 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Our inspection site visit was on the 20 and 24 September 2018 and was announced. We gave the service 48 hours' notice of the inspection visit because we wanted to give the provider enough time to prepare information we needed as part of our inspection process and to ensure the registered manager would be available because the service was small.
The inspection was prompted in part by information provided by the local authority about an incident following which a person using the service sustained a serious injury. This incident is subject to a safeguarding investigation by the local authority.
However, the information shared with CQC about the incident indicated potential concerns about the management of falls, unsafe medicines management and unsafe use of equipment. This inspection examined those risks.
The Inspection team consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.
We reviewed information we held about the service this included notifications received from the provider about deaths, accidents/incidents and safeguarding alerts, which they are required to send us by law.
We visited the provider's main office location and we spoke to three people, three relatives and four members of staff. The registered manager had recently left the service and the provider was in the process of recruiting to the post so the regional service lead was available to support the inspection. We looked at the care records for three people, the recruitment and training records for three members of the care staff and records used for the management of the service; for example, staff duty rotas, accident records and records used for auditing the quality of the service.
Updated
26 October 2018
The inspection took place on 20 and 24 September 2018 and was announced. We gave the service 48 hours' notice of the inspection visit because we wanted to give the provider enough time to prepare information we needed as part of our inspection process. This would ensure the registered manager would be available because the service was small. The inspection was prompted in part by information provided by the local authority about an incident following which a person using the service sustained a serious injury. This incident is subject to a safeguarding investigation by the local authority.
This inspection was carried out to check on how people were being supported due to concerns identified by the local authority about risks to people. The last inspection of this service in September 2015 rated the service as ‘Good’ overall with a ‘Requires Improvement’ in the Safe question.
Dudley and Wolverhampton Domiciliary Care is registered to provide personal care services to people in their own houses and flats in the community and specialist housing. This service is a domiciliary care agency. It provides a service to older adults, younger disabled adults and children.
This service provides care and support to people living in a number of ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
On the day of the inspection there were 26 people receiving support. There was no registered manager in post as they had recently left. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.
Care staff were trained to recognise risks to people to keep them safe. There were enough care staff to ensure people were supported timely and medicines were administered. Care staff were provided with personal protective equipment to support people in a way that reduce the risks of infection.
Training was provided to care staff so they had the skills and knowledge to meet people’s needs. People made their own decisions as to how they were supported. The provider adhered to the Mental Capacity Act (2005).
Care staff supported people in a friendly and kind manner. People were involved in the assessments and care planning process so they could be supported how they wanted. People were supported respecting their privacy, dignity and independence.
People’s views were listened to in how they were being supported. The provider had a complaints process in place to enable people to raise concerns they may have.
The provider carried out spot checks and audits but these were not effective in ensuring the quality of the service was maintained. Care records did not consistently reflect accurately or clearly people’s support needs.
While people could complete a questionnaire to share their views on the service they received, the provider did not ensure the outcomes and actions from the process was shared with people.