Background to this inspection
Updated
27 April 2022
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
This announced inspection was carried out by one 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was 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 21 March 2022 and ended on 4 April 2022. We visited the location’s office on 21 March 2022.
What we did before the inspection
We reviewed information we had received about the service since its registration. We sought feedback from the local authority and we used information gathered as part of monitoring activity that took place on 24 February 2022 to help plan the inspection and inform our judgements. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with the registered manager. We reviewed a range of records. This included two people’s care records and one person’s medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including safeguarding records, quality assurance records and training records were looked at.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with two people who used the service, three relatives and two care staff members.
Updated
27 April 2022
About the service
DCI Care is a domiciliary care agency (DCA). The service provides personal care services to people in their own homes. This includes Live-in Care, where staff live with people in their own homes. At the time of our inspection two people received personal care as the regulated activity.
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.
People’s experience of using this service and what we found
There were systems in place to monitor the quality of service. However, these systems were not always effective. Medicines management was not based on current best practice, therefore we have made a recommendations about staff competencies.
People were not always protected against the employment of unsuitable staff as the provider failed to follow safe recruitment practices.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not always support this practice. Therefore, we have made a recommendation about the Mental Capacity Act 2005.
People's dignity, confidentiality and privacy were respected, and their independence was promoted. However, we identified that our findings in relation to training, staff had not always received the appropriate training in Mental capacity Act (MCA) and end of life care (EoLC) to support them in their roles.
Risk assessments identified how potential risks should be managed to reduce the likelihood of people experiencing harm. Staff understood the risks to people and delivered safe care in accordance with people's support plans. Staffing rotas showed there were sufficient staff to meet people's needs.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 14 April 2021 and this is the first inspection.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to safe recruitment, staffing and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.