Background to this inspection
Updated
24 July 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 took place because we rated the service as ‘requires improvement’ at our last inspection in May 2017. Therefore, it was time for us to return and check improvements had been made. The office visit took place on 28 June 2018 and was announced. We told the provider 48 hours before our visit we would be coming so they could make sure they would be available and so they could arrange for staff to take to us.
This comprehensive inspection was carried out by 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 care service.
Prior to our inspection visit we reviewed the information we held about the service and reviewed the statutory notifications that had been sent to us. A statutory notification is information about important events, which providers are required to send to us by law.
The provider had sent us a list of people who used the service before our inspection. We sent questionnaires to 12 people who used the service and received 4 responses back, 12 were sent to people's relatives and we received 4 responses. We looked at the feedback from the questionnaires and reviewed the information to form part of our judgements.
The registered manager had completed a provider information return (PIR). The PIR is a form that asks the provider to give some key information about the service at least once annually to give us some key information on what the service does well and improvements they plan to make. The information reflected the service we saw and we considered it when making our judgement.
Before the inspection visit we reviewed the information we held about the service. We looked at the information received from our 'Share Your Experience' web forms and the statutory notifications the provider had sent us. A statutory notification is information about important events which the provider is required to send to us by law.
We reviewed four people's care records to see how their care and support was planned and delivered. We looked at two staff records to check whether staff had been recruited safely and were trained to deliver the
care and support people required. We looked at other records related to people's care and how the service operated, including the service's quality assurance audits and records of complaints.
Following our visit we spoke with three people who used the service and six people’s relatives via the telephone to give them the opportunity to share their views on the service and the care and support they received.
Updated
24 July 2018
Dixon Dunn Care Solihull Limited is a domiciliary care agency. It provides personal care to people living in their own homes. There were 19 people using the service at the time of this inspection.
Dixon Dunn Care Solihull Limited is part of the Home Instead Senior Care national franchise. A franchise is when a franchisee (the provider) has bought the right to sell a specific company's (the franchisor's) products in a particular area using the company's name.
This announced inspection took place on 28 June 2018. We told the provider 48 hours before the visit we would be coming so they could make sure they would be available to speak with us and arrange for us to speak with care workers.
The service is required to have 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 and associated Regulations about how the service is run. A registered manager was in post.
The service was last inspected on 11 May 2017 when we rated the service as ‘requires improvement’. The provider had learnt lessons since that inspection and had taken action to make improvements.
People felt safe with the staff that provided their care and support. Risk assessments contained up to date information to support staff to provide safe care. Staff understood the risks associated with people's care and knew how to manage risks.
Procedures were in place to protect people from harm. The registered manager was aware of their responsibilities to keep people safe. All staff had received ‘safeguarding adults’ training to support them to understand what constituted abuse.
The provider's recruitment procedures minimised the risks to people's safety. Enough care workers were available to support people at the times they preferred and people confirmed care workers arrived at the times they expected them. An electronic system was used by the provider to check people had received their care. The provider had systems to record and review any accidents and incidents that occurred.
The management of people’s medicines had improved since our last inspection. We checked and found people had received their medicines as prescribed. The system for recording medication errors meant action could be taken in a timely way to keep people safe if errors occurred.
People told us staff had the right skills and knowledge to meet their needs. New staff received the support and the training they needed to be effective in their roles. Staff spoke positively about their training and a programme of regular updates supported them to keep their skills and knowledge up to date.
Staff knew how to manage people's nutrition and hydration which included encouraging them to eat to maintain their health. People felt confident care workers would support them if they needed to attend any health appointments. Staff followed good practice and understood their responsibilities in relation to infection control.
People told us all of the staff were kind and caring. Relatives supported this viewpoint and told us they would recommend the service to others. Staff thought the service was caring because they provided consistent care to the same people which meant meaningful relationships had developed. People were supported to develop friendships which had a positive effect on their wellbeing.
People received care and support that was responsive to their needs. People and their families were involved in the planning and review of their care. People's care plans were written in a personalised way and included a brief life history and information about their preferred routines and lifestyle choices from their perspective.
People chose how they spent their time and staff knew the importance of people being involved in making decisions. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff supported people to maintain their independence. People confirmed care workers treated them with respect and maintained their dignity. Staff understood the importance of maintaining people's confidentiality.
People and staff spoke positively about the way the service was managed. Staff felt cared for and supported by their manager because they received regular supervision and observations of their work performance. They also attended team meetings where they discussed ideas for improvements.
Audits and checks to assess and monitor the quality of the service were effective which assured us improvements had been made since our last inspection.
People felt assured that complaints would be taken seriously and acted upon. People were encouraged to share their views on the service they received. The feedback gathered was used to drive forward improvement.
Since our last inspection the provider had increased their community links and the service was an active part of the local community.
The registered manager understood their responsibilities and the requirements of their registration.