Archived: Direct Health (Warrington)

The service was last inspected on 27 November 2013 where it was found to be compliant in all the areas that we looked at.

Direct Health (Warrington) has 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.

Direct Health (Warrington) is an agency providing personal care and support to people in their own homes. It predominantly provides the service in the Warrington and Salford areas. At the time of our inspection, they were providing services to 60 people in Warrington and 87 in Salford who all experienced various care needs from social support to maintaining their independence with full personal care needs. Visits ranged from fifteen minutes for up to six hours to give respite to family carers.

During this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There were ineffective systems in place for the safe management of medicines. You can see the action we told the provider to take at the back of the full version of this report.

The people who used the service and their relatives told us that they were treated with respect and kindness by the staff. Comments included, “The lady who comes here is the most wonderful caring person I could hope for” and “Nothing is too much trouble for the staff, they are all wonderful”.

People told us they felt safe with the staff and that they assisted them to maintain their independence wherever possible. We saw that there were systems in place to manage risks to people. For example we saw that staff had made referrals to the local health and social care agencies for equipment to keep people safe. This demonstrated that they continually assessed people’s changing needs to ensure they were safe.

Records showed that staff were trained to undertake risk assessment which meant they could identify issues in both the home environment or risks to people’s safety.

Arrangements were in place to protect people from the risk of abuse. We spoke to staff about their understanding of safeguarding and they knew what to do if they suspected that someone was at risk of abuse or they saw signs of abuse. Relatives of the people who used the service told us that they felt that their relatives were safe and supported by the staff of Direct Health (Warrington).

The service actively involved people in their assessment which enabled them to make choices about the support they needed. People told us that they were able to make changes to times of visits if they had doctor or hospital appointment or if they had a social engagement.

We looked at recruitment files for the most recently appointed staff members to check that effective recruitment procedures had been completed. We found that appropriate checks had been made to ensure that staff were suitable to work with vulnerable adults.

People’s care and support was planned in partnership with them and their relatives and they told us they generally received support from a regular team of care staff who understood their needs. The care files that we looked at contained the relevant information that staff needed to care for the person in a manner of their choice.

People were supported to take their medicines however the medicines records were inconsistent. People had support plans in place but they did not identify clear details of medicines required and the medicine administration records (MAR) contained conflicting information. The registered manager was aware of this and was in the process of updating the systems to ensure they fully detailed the medicines prescribed and the dates and times they were to be administered.

Discussions with staff members identified that they felt happy and supported in their roles. They told us that the registered manager was supportive and she was easy to talk to. Comments included, “We are supported and not afraid to ask her (manager) anything”, and “We get training and supervision and can ask for training in anything we need and it will be provided”.

The service promoted an open and honest culture and the managers and care co-ordinator were transparent in their discussions with us. The registered manager was committed to continuous improvement and welcomed feedback as an opportunity to monitor and evaluate the services provided. There was a quality assurance system in place which used various checks and audit tools such as questionnaires and direct observations to monitor and review the practices within the service.

Comments such as "staff are excellent", " they do the job, come on time and are very good' and " they treat me with dignity" were made.

When we spoke with people who use the service they said "The staff are very helpful and go out of their way to help"

A relative spoken with said "I dont know what I would do without them my husband says they are magic"

Comments such as "staff are very efficient, quick and competent," "my carers are the best I have ever had, " and "they maintain a good level of service." were seen to be written on survey forms which had been sent out to people and their families.