Archived: Home Care Direct

Updated 16 November 2015

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 team consisted of 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 service.

Before the inspection we checked the information that we held about the service and the service provider. We looked at notifications sent to us by the provider. A notification is information about important events which the provider is required to tell us about by law.

During the inspection, we spoke with three care workers, one independent living nurse (ILN), the marketing manager, the lead independent living advisor, the training manager, the registered manager and a director. Due to the nature of their individual disabilities and very complex care and support needs, it was not possible to speak with any of the people using the service. However, as part of the inspection process we spoke, by telephone, with nine relatives of people and three personal assistants (PA). We also looked at documentation, which included four people’s care plans, incorporating comprehensive risk assessments, as well as staff training files and records relating to the management of the service.

The previous inspection was on 10 September 2014 when the service was found to be ‘non-compliant’ in several areas, including safeguarding people, supporting staff and quality assurance monitoring.

Updated 16 November 2015

Homecare Direct is a specialist third party option service, which arranges and coordinates support for people in their own home throughout England and also in Northern Ireland. The service is funded through various streams, including direct payments, personal health budgets and private compensation funding. Homecare Direct operates from an office in Derbyshire, using locally based support staff in other areas of the country. The service is used by adults and children with a range of needs and various conditions, including learning and physical disabilities.

We carried out this inspection on 29 September 2015. It was an announced inspection, which meant the provider knew we would be visiting. This was because we wanted to make sure that the registered manager, or someone who could act on their behalf, would be available to support our inspection.

At our last inspection of this service on 10 September 2014, we found that the provider did not have appropriate arrangements for safeguarding people, supporting staff and quality assurance monitoring. These were breaches of Regulations, 11, 23 and 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which correspond with Regulations 13, 18 and 17, of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the inspection, the provider told us about the action they were taking to address this and at this inspection we found that the required improvement had been made.

A registered manager was 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.

Staff were appropriately recruited, trained and supported. They had all undergone a comprehensive induction programme and, where necessary, had received additional training specific to the needs of the people they were supporting. Communication was effective and regular meetings were held to discuss issues and share best practice. Staff understood their roles and responsibilities and spoke enthusiastically about the work they did and the people they cared for.

The provider had detailed policies and procedures relating to medicine management. Staff understanding and competency regarding the management of medicines was subject to regular monitoring checks and medicine training was updated appropriately.

Staff knew the people they were supporting and provided a personalised service and used effective systems for gaining consent. Individual care plans, based on a full assessment of need, were in place detailing how people wished to be supported. This helped ensure that personal care was provided in a structured and consistent manner. Risk assessments were also in place to effectively identify and manage potential risks.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the management staff understood when an application should be made and how to submit one.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.

Systems were in place to effectively monitor the safety and quality of the service and to gather the views and experiences of people and their relatives. The service was flexible and responded positively to any issues or concerns raised. People and their relatives told us they were confident that any concerns they might have would be listened to, taken seriously and acted upon.