Archived: DIL Foundation

Updated 25 February 2016

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.

The inspection took place on 13 January 2016. We gave the provider 24 hours’ notice to ensure there was someone in the office on the day of the inspection.

The inspection team consisted of two adult social care inspectors from the Care Quality Commission.

We did not ask the service to complete a Provider Information Return (PIR), which is a form that asks the provider to give some key information about the service, prior to the inspection. We reviewed information we held about the service in the form of notifications received from the service.

We did not speak to people who used the service as a number of them were away at the time of the inspection and others had difficulties with communication and language. However we did speak with four relatives of people who used the service. We spoke with four care staff, as well as the registered manager. We looked at records held by the service, including four care plans, four staff files, meeting minutes, training certificates and other records supplied by the provider.

Updated 25 February 2016

The inspection took place on 13 January 2016 and we gave the service 24 hours’ notice to ensure there was someone in the office. At the last inspection there were five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches related to setting up systems to investigate potential abuse, consent, safe recruitment of staff, suitability of management and staff support. We saw that actions required of the service had been completed and improvements had been made in all of the above areas so there were no continuing breaches.

DIL Foundation Registered office is located on the first floor inside a newly renovated church, which is being used for the local community. The Church is located off one of the main roads of Bolton which is less than a mile away from Bolton Town Centre and Bolton Train Station.

DIL Foundation offer a range of domiciliary care services, including cooking, cleaning and personal care. On the day of the inspection there were 24 people using the service, although six of these were currently on long visits to Asia.

The service had a manager in place who was registered with the Care Quality Commission (CQC). 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.

At our previous inspection we found that the provider had failed to establish systems and processes to investigate allegations of abuse. This was a breach of regulation 13 (2) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we saw that appropriate protocols were in place and staff were able to recognize issues and demonstrated knowledge of safeguarding procedures. We found that the previous breach of regulations had been addressed by the service.

At our previous inspection we found that staff had not been recruited safely and the provider had failed to ensure that fit and proper persons were employed. This was a breach of regulation 19 (2) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff unsafely recruited had now ceased to work for the service. A new robust recruitment procedure had been implemented by the registered manager. The previous breach of regulations had been addressed and we found that people currently employed by the service had been recruited safely.

Staffing levels were appropriate and no missed or late visits were reported.

Care files included appropriate risk assessments. These included health and safety, moving and handling, trips out and road safety.

Medicines policies were in place, staff were appropriately trained and medicines were administered safely. Appropriate financial records were in place.

At the previous inspection we found that there was not a system in place of regular formal supervision meetings. This was a breach of Regulation 18 (2) (a) of the Health and Social Care Act 2008 (Regulations) 2014.

The registered manager had now implemented a robust supervision programme which was on-going for all staff. This had addressed the previous breach of regulations.

At the previous inspection we found that the service was not working within the principles of the MCA. This was a breach of Regulation 11 (3) of the Health and Social Care Act 2008 (Regulations) 2014. At this inspection we found that this breach had been addressed via staff training and awareness raising.

There was evidence within the staff files we looked at that all staff had undertaken a comprehensive induction programme and training for all staff was on-going.

Care files included a range of health and personal information, including particular requirements and preferences.

We saw that consent was sought from people who used the service when appropriate.

Relatives of people who used the service that we spoke with told us the staff were kind and caring. People’s dignity and privacy was respected.

There was an appropriate confidentiality policy in place and staff were aware of the importance of confidentiality within their work.

There was appropriate information produced to ensure people were aware of what to expect from the service.

Staff were aware of the importance of giving choice and were able to explain how they did this within their work.

There was an appropriate complaints policy in place and people who used the service were aware of how to make a complaint. No complaints had been received by the service.

We saw a number of thank you cards received by the service.

At the previous inspection we found that the provider had not implemented systems to assess, monitor and improve the quality and safety of the services provided in the carrying on of the regulated activity (including the quality of the experience of service users in receiving those services). This was a breach of Regulation 17 (2) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection we saw that the registered manager had implemented a range of systems to assess the quality of the service. For example a customer satisfaction survey had recently been undertaken and this showed that 100% of the people who used the service were very satisfied with the care delivery. There was evidence of care plan reviews, monitoring and analysis of accidents and incidents and complaints and monitoring of staff competence.

These systems had addressed the previous breach of regulations.

People who used the service, their relatives and staff members at the service all described the management team as approachable and there was a member of the team on call at all times.

Staff meetings took place on a regular basis and provided a forum for staff to raise any issues or concerns. Minutes of the meetings were documented.