Archived: South Derbyshire Area Office (DCC Home Care)

There was a registered manager in the service. 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 last inspection in July 2016 we rated the service Good. At this inspection we found improvements were now needed. The service is rated as requires improvement overall.

People did not always receive their care at the right time and people found that their care was not consistent as different staff, some who they did not know well, provided their care. People did not always receive their call and there was no evidence that any action had been taken to safeguard people when calls were missed. Staff were trained to recognise the various forms of abuse and encouraged to report any concerns. However, where people had calls missed, this had not been identified that this may mean they were at risk of harm or neglect. The quality monitoring systems did not identify where improvements were needed and missed calls, accidents and serious incidents were not monitored. We did not receive notifications of significant events to show how the provider had responded to events.

People did not always have care plans which recorded the care they were receiving and assessments of risks had not always been completed to ensure any risks were minimised. Care had not always been reviewed when this was needed which meant staff did not always have the information they needed to provide care safely.

Medicines were not managed safely where people received their medicines in boxes and checks were not made to ensure people had these as prescribed.

People felt able to complain but were not confident that their concerns were always actioned. The provider had not recognised that complaints were not recorded and responded to.

Improvements were needed to ensure that people were supported to have maximum choice and control of their lives and for staff to support them in the least restrictive way possible. People could make decisions about their care although improvements were needed to ensure where concerns about people’s capacity was identified, assessments were completed and decisions made in their best interests.

People retained their independence and staff respected this. Staff developed caring relationships with the people they supported which were respectful and staff were kind and patient and took an interest in them and their family. People’s privacy and dignity was maintained and people felt comfortable with staff they knew.

Recruitment systems were in place to ensure new staff were suitable to work with people. The provider had infection control procedures in place and personal protective equipment was available in people’s homes for staff to use. Personal emergency evacuation plans had been developed to guide staff how to support people to leave their homes in the event of an emergency situation.

People’s health needs were monitored and the staff worked with health care professionals and helped people to attend appointments where necessary. When people required assistance to eat and drink, the provider ensured that this was planned to meet their preferences and assessed need.

People were asked for their feedback on the quality of the service. The results of the survey were reviewed and people were informed of where the service needed to make improvements within a newsletter.

People felt the staff had the right skills to provide the care they wanted. Staff received training to understand how to support people and their competence was checked to ensure they had developed the skills they needed from the training. Staff received ongoing support and felt the management team was approachable and that they could talk to them at any time.

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.

There was a registered manager in post. 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.

The manager was supported by five domiciliary organisers who each had responsibility to an area, covering all the care needs and the staff within that location. The staff told us they felt supported by this network and we saw how they received ongoing supervision and meetings to support their development. Staff received training in a range of areas to enable them to carry out their role and had the opportunity to access further training.

People told us they felt safe and the staff knew how to report any concerns to ensure people were protected from harm. Risk assessments had been completed for the environment and specific needs. The assessments identified guidance and ways to reduce any identified risk.

There were sufficient staff to support people’s needs and people told us they received support from a regular group of staff which they found reassuring. Where people required support with their medicine this was completely safely and in line with the appropriate training and guidance.

People were given choices and supported to make decisions. Where they were unable to make some decisions independently these had been made through an assessment and in the person’s best interest.

Some people required support with their meals. They were given choices on the meal they wished to eat and in some situations a recording of the meal was completed to ensure the person was receiving the appropriate levels required for their nutritional needs.

People told and we saw they were treated with kindness and compassion. Their dignity was respected in aspects of the care they received. We saw the service was responsive and was able to change the support offered dependent on the needs of the person’s situation.

The provider and manager completed a range of audits to use to maintain the quality of the service or to make improvements. People felt positive about the service and able to approach them if they required any changes to their care needs. Complaints had been addressed in line with the organisations policy.

Care workers received training in food hygiene and were able to help people who needed help with their diet.

We found appropriate arrangements were in place in relation to obtaining medicine. Where relatives were around to do help in this way they were encouraged to do so.

People using the service told us they knew who was visiting their home and liked this because it helped them to plan the rest of their day and it made them feel safer.

People were able to express their comments about the service and knew they would be listened to and acted on. This was helpful as part of the quality review of the service.