Background to this inspection
Updated
25 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 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.
This comprehensive inspection took place between 16 and 23 May 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is a community based service and we needed to be sure the office would be staffed. The inspection was carried out by two adult social care inspectors.
Inspection site visit activity started on 16 May and ended on 23 May 2018. It included a visit to the office location on 16 May 2018 to see the registered manager and office staff; and to review care records and policies and procedures. We made telephone calls to staff, people and relatives on 22 and 23 May 2018.
During the inspection we spoke with eight people and two relatives. We also spoke with five members of staff, including the registered manager, and five care workers. We looked at five people’s care records and eight people’s medicine records. We reviewed four staff files, including records of the recruitment process. We reviewed supervision, appraisal and training records as well as records relating to the management of the service.
Before the inspection took place we reviewed the information we held about the service. This included notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to let us know about. We used the information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
As part of our inspection planning we contacted the local authority commissioners of the service, the local authority safeguarding team and the local Healthwatch to gain their views of the service provided. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
Updated
25 July 2018
The inspection took place on 16, 22 and 23 May 2018. This is the first time we have inspected the service since it was registered in April 2017.
Direct Health (Tyneside) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of the inspection there were 108 people receiving a service.
The service had a registered manager in place. 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.
People and their relatives told us people felt safe receiving support from staff. Staff had completed training in safeguarding and the registered manager actively raised any safeguarding concerns with the local authority.
Risks to people’s safety and wellbeing were assessed and managed. Environmental risk assessments were in place in relation to people’s own homes.
People’s medicines were administered in accordance with best practice and managed in a safe way.
People, relatives and staff felt there were enough staff to meet people’s needs. There were mixed views regarding the timeliness of calls but people relayed these weren’t frequent issues. Staff were recruited in a safe way.
New staff told us they received a structured induction programme and they found this supported them in their roles and prepared them to deliver care to people safely. Staff received regular training, supervisions and annual appraisals to support them in their roles.
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. The principles of The Mental Capacity Act 2005 were applied appropriately in this service.
People were supported to meet their nutritional needs and to access a range of health professionals. Information of healthcare intervention was included in care records.
People and relatives felt the service was caring and staff were friendly. Staff treated people with dignity and respect when supporting them with daily tasks. People were supported to be as independent as possible.
People had access to advocacy services if they wished to receive support.
Care plans were in place for meeting each person's individual needs. They were personalised, detailed and included people’s preferences. Regular reviews were carried out with people about their care and support.
People and their relatives told us they knew how to raise any concerns they had about the service. The provider had a complaints procedure in place and kept a log of any complaints received. All complaints received were investigated, acted upon and outcomes were fed back to complainants.
There were audit systems in place to monitor the quality and safety of the service. The views of people and staff were sought by the registered manager via annual questionnaires. All results were analysed and improvements were made where identified.