Archived: Derbyshire care Services Central and West

Updated 9 August 2017

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 was 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.

This inspection took place on 20 and 22 June 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available at the office.

The inspection was carried out by two inspectors 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 care service. The expert-by-experience did not attend the agency’s office, but spoke by telephone with people who used the service and relatives. The telephone interviews took place on 20 and 21 June 2017.

We checked the information we held about the service and the provider. This included notifications the provider had sent to us about significant events at the service and information we had received from the public, the local authority and other relevant professionals.

We did not send the provider a Provider Information Return (PIR) prior to this inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However, we gave the management team the opportunity to provide us with information they wished to be considered during our inspection.

We spoke with eight people who used the service and seven people’s relatives. We spoke with the registered manager, the registered person, a director and three care staff who supported people in their homes.

We reviewed records which included four people’s care records to see how their care and treatment was planned and delivered. We reviewed five staff employment records and other records which related to the management of the service such as quality assurance, staff training records and policies and procedures.

Updated 9 August 2017

This inspection took place on 20 and 22 June 2017 and was announced. The provider was given 48 hours' notice. This meant the provider and staff knew we would be visiting the service’s office before we arrived. This was the first inspection since the provider's registration on 10 October 2016.

Derbyshire care Services Central and West is a domiciliary care agency providing personal care to older people and younger adults in their own homes across the central and west areas of Derby including Littleover, Mickleover and Allestree. This included people with physical disabilities and mental health. The agency is located close to Derby city centre. At the time of our inspection 182 people received the regulated activity of personal care.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission. 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.

We found that the provider's quality assurance systems had not picked up the issues we identified at this inspection visit. This demonstrated that the management systems were not always effective in recognising areas which required improvements.

The provider's arrangements for staff recruitment were unsafe and did not ensure suitable people were employed. We found that all the required pre-employment checks were not in place.

The Mental Capacity Act (MCA) 2005 helps to ensure that people are supported to make their own decisions wherever possible. Where people were identified as not having capacity there were no records of best interest decision making to show the care and support provided was in the person’s best interests. Care staff's knowledge on the MCA varied and not all care staff had been trained in this area. Training records also showed that care staff had not received training in all areas as identified by the provider.

People were not consistently involved in reviewing what support they needed. People told us they appreciated regular care staff; where people did not receive regular care staff they felt their care was compromised in a variety of ways.

People received appropriate support to manage their meals and nutrition when required. This was done in a way that met with their needs and choices. People’s health needs were met, care staff confirmed if they were concerned about people’s health care needs they would notify the office or contact the relevant service as required.

People told us care staff treated them in a caring way and respected their privacy. Care staff supported people to maintain their dignity. The delivery of care was tailored to meet people’s individual needs and preferences.

Care staff told us they felt supported by the management team and told us they received regular supervision.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.