Background to this inspection
Updated
19 June 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.
This inspection took place on 23 and 24 April 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because the registered manager is often out of the office supporting staff or visiting people. We needed to be sure that they would be in.
On 23 April 2018, we visited five people who received support at their homes to ask their opinions of the service and to check their care files. We also spoke with three relatives of people receiving support during visits.
On 24 April 2018, we visited the service’s office on to see the registered manager, some staff and to review care records, policies and procedures.
The inspection team consisted of three adult social care inspectors, an assistant adult social care inspector 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. The expert by experience had experience in caring for older people.
Prior to the inspection, we gathered information from a number of sources. We reviewed the information we held about the service, which included correspondence we had received and notifications submitted to us by the service. A notification should be sent to CQC every time a significant incident has taken place. For example, where a person who uses the service experiences a serious injury. We reviewed the Provider Information Return (PIR), which the registered provider completed before the inspection. The PIR is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.
We contacted Sheffield local authority and Healthwatch (Sheffield) to obtain their views of the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. All of the comments and feedback received were reviewed and used to assist and inform our inspection.
We spoke with the registered manager, the interim head of home care, the deputy manager, a care coordinator, an assessor, a senior care worker and three care workers in person during the visit to the office. We spoke over the telephone with seven care workers to obtain their views.
We telephoned 14 people who received support and spoke with them, or their relatives, to obtain their views of Direct Health (Sheffield).
We reviewed a range of records, which included care records for eight people, four staff training, support, and employment records and other records relating to the management of the domiciliary care agency.
Updated
19 June 2018
Direct Health is a domiciliary care agency. It is registered to provide personal care to people living in their own houses and flats in the community. The services office is based in the S9 area of Sheffield, close to local amenities and transport links.
At the time of this inspection, 523 people were receiving support and 259 care workers were employed.
There was a manager at the service who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.
Direct Health is an established care provider and has been operating in Sheffield for many years. The registered provider of the service transferred to Accord Housing Association Limited in April 2017. This is the service’s first inspection under their new registration.
This inspection took place on 23 and 24 April 2018 and we gave the registered provider 48 hours’ notice of our inspection to make sure the registered manager, some staff and some people receiving support would be available to meet and speak with us.
We received mixed views from people about the support provided to them. Some people spoke very positively and told us they felt safe and their care workers were respectful and kind. Some people told us they received a consistent and reliable service that met their needs. Other people had concerns about the times of their visits. A few people told us they had not always found some care workers respectful. We shared specific concerns with the registered manager who took immediate action to resolve these concerns and improve people’s experience.
We found systems were in place to administer people’s medicines safely. The service adhered to the local authority policy for the safe administration of medicines. Systems were monitored and any errors were reported and acted on to prevent reoccurrence.
We found there were systems in place to protect people from the risk of harm. Staff we spoke with were able to explain the procedures to follow should an allegation of abuse be made. Assessments identified risks to people, and these were regularly reviewed to ensure people's safety.
Robust recruitment procedures were in operation and promoted people’s safety.
Staff were provided with relevant training, supervision and appraisal for development and support.
There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider’s policies and systems supported this practice. People had consented to receiving care and support from Direct Health (Sheffield).
People were supported to maintain a healthy diet, which took into account their culture, needs and preferences, so their health was promoted and choices could be respected.
People said they could speak with their care workers or the registered manager if they had any worries or concerns and they would be listened to. Some people said they experienced poor communication from the office staff.
We found a system was in place to monitor service delivery.