Background to this inspection
Updated
24 January 2020
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 Care Act 2014.
Inspection team
This 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.
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.
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 and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with three members of staff including the registered manager, deputy manager and office staff. We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with three people who used the service on the telephone to talk to them about their experience and three members of staff.
Updated
24 January 2020
About the service
Direct Independent Care Limited is a domiciliary care agency providing personal care to 15 people aged 65 and over at the time of the inspection, this included ‘live-in care’. At the last inspection the service was supporting 23 people.
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
Improvements had been made since the last inspection. This included new risk assessment processes. This also included new and retrospective pre-assessments completed to ensure the service could meet people’s needs.
Management had also introduced a new quality assurance audit system which identified any needs or concerns that required action. We saw from records any concerns identified were being actioned.
People were being supported safely with their medicines, and new audits for medicine administration records (MARs) had been introduced. This ensured that people were receiving their medicines at the correct time, and any errors were identified quickly. People were kept safe from the risk of infection.
People told us that they were well supported by kind and caring staff who were competent and well trained in delivering care. Training records supported this, showing that all staff were up to date with mandatory training. People were kept safe by staff who understood different types of abuse and how to report any concerns correctly.
Staff were supported by a management team who completed regular supervision and sought regular feedback from staff. This ensured staff were comfortable to carry out their role and confident to raise any issues. Staff were recruited safely and there were enough staff deployed to keep people safe and meet people’s needs.
Staff respected people’s privacy and dignity and encouraged independence where appropriate. People told us they were treated with respect and kindness.
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; the policies and systems in the service supported this practice.
People were supported to express their views and there was a clear complaints policy that was available to every person using the service. Where people had complex communication needs staff supported them with different communication aids, this was all documented in individual care plans.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 05 December 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.