Dunamis Social Care

Updated 3 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried by 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was announced.

We gave a short period notice of the inspection because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 11th May 2023 and ended on 13th June 2023. We visited the location’s office on 11th May 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. Please see the well-led section of the full inspection report for further details. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who used the service and 3 relatives about their experience of the care provided. We spoke with 5 members of staff including the registered manager, care co-ordinator, and care workers. We reviewed a range of records. This included 4 people's care records and 3 medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service including governance audits, policies and procedures were reviewed.

Updated 3 August 2023

About the service

Dunamis Social Care is a domiciliary care agency. It provides personal care to people in their own homes. The service provides support to people with dementia, people with physical disabilities, sensory impairment and people with a learning disability and autistic people. At the time of our inspection there were 25 people using the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

People’s experience of using this service and what we found

Right Support:

People had been recruited into the service without references being verified. Systems were not in place to robustly check the recruitment process. We have made a recommendation about the recruitment of staff.

Staff training did not include topics staff needed to be aware of, such as training in dignity and specific health conditions. We saw no evidence of harm of this lack of training. However, there was a risk staff may not understand and act on people's health needs.

People had their needs assessed before care was delivered. People were supported to have maximum choice and control of their lives, this meant staff were able to support them in the least restrictive way possible and in their best interests; the policies and systems in the service did support this practice.

The service protected people from the risk of poor nutrition and dehydration. People were supported by staff to prepare meals and drinks to meet their needs.

The service worked with medical professionals. This included working with district nurses to assist a person with pressure area needs. People were confident their healthcare needs were met.

Right Care:

People's care, treatment and support plans had not always been updated and did not show how people had been involved. The registered manager had identified care plans needed improvement and was in the process of updating them.

Staff had training on how to recognise and report abuse and they knew how to apply it. Systems and processes identified and protected people from abuse. People told us they felt safe with staff.

Medicines were managed safely. Electronic medication administration charts (eMAR) had been completed and showed people had their medicines as prescribed. Systems and processes flagged when records were not completed.

Staff had access to personal protective equipment (PPE) and people told us staff wore this appropriately, kept their homes clean and were regularly observed to wash their hands.

People received kind and compassionate care. Staff protected and respected people's privacy and dignity.

Right Culture:

Systems and processes were not always robust to ensure good governance of the service. Audits did not identify the concerns reported on during this inspection. This placed people at risk of not having their care needs met.

People told us the registered manager and staff were kind, caring and their needs were met. One relative told us, "Best care [our relative] has ever had. It has made a huge difference. We can appreciate how good they are.”

The registered manager was open and transparent throughout the inspection. They told us their focus had been working with new staff.

Staff felt supported by the registered manager. Staff told us they were happy to work for Dunamis Social Care and people felt they received good care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 8 July 2022).

Why we inspected

We received concerns in relation to staffing. As a result, we undertook a focused inspection to review the key questions of good, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.

The registered manager assured inspectors that they were managing their financial commitments and they had recently recruited regular care staff to ensure continuity of care for people.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dunamis Social Care on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.