Background to this inspection
Updated
4 December 2020
The inspection
As part of a pilot into virtual inspections of domiciliary and extra-care housing services, the Care Quality Commission (CQC) conducted an inspection of this provider between the 4 November 2020 and 19 November 2020. The inspection was carried out with the consent of the provider and was part of a pilot to gather information to inform CQC whether it might be possible to conduct inspections in a different way in the future. We completed this inspection using virtual methods and online tools such as electronic file sharing, video calls and phone calls to gather the information we rely on to form a judgement on the care and support provided. At no time did we visit the provider’s or location’s office as we usually would when conducting an inspection.
Inspection team
The inspection team comprised of two inspectors, one of them being a medicines inspector. They were supported by CQC support services 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
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period notice of the inspection because the office was closed due to the COVID -19 pandemic and the registered manager needed to access the building to provide the relevant information.
Inspection activity started on 4 November 2020 with calls to people who used the service and ended on 19 November 2020.
What we did before 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.
During the inspection
We spoke with 28 people who used the service and nine relatives, about their experience of the care provided. We spoke with five members of staff including the registered manager and care workers.
We reviewed a range of records. This included 12 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 quality audits, surveys, policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
4 December 2020
This report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the provider.
About the service
Direct Health Preston is a domiciliary care agency providing personal care and support to 91 people aged 18 and over at the time of the inspection.
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
People described staff as kind and caring and their support as good. They felt involved in their care and support. Care was personalised and people's differing needs were responded to.
People felt safe with staff members, who had been trained to protect people from the risks of abuse. The provider had systems in place to check the suitability of staff, who were trained, and checks were undertaken on their skills and competencies.
There was consistency in which staff supported people. Risk management plans were included in people's care plan which staff could refer to. People were supported with their prescribed medicines as needed by trained care staff.
Staff understood infection prevention and control measures and actions they should follow in line with COVID-19 pandemic guidance.
Staff followed professional healthcare guidance where this had been given. People were supported to access healthcare services if required.
Staff worked within the principles of the Mental Capacity Act 2005 and understood the importance of gaining consent from people. People were supported to have maximum 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.
There were quality assurance systems in place to check the safety and quality of the services. Compliance checks were made by the provider and had identified where improvements were needed and these had been acted on.
Rating at last inspection
The last rating for this service was Good (report published 7 June 2018).
Why we inspected
This was a planned pilot virtual inspection. The report was created as part of a pilot which looked at new and innovative ways of fulfilling CQC’s regulatory obligations and responding to risk in light of the Covid-19 pandemic. This was conducted with the consent of the provider. Unless the report says otherwise, we obtained the information in it without visiting the provider.
The pilot inspection considered the key questions of safe and well-led and provide a rating for those key questions. Only parts of the effective, caring and responsive key questions were considered, and therefore the ratings for these key questions are those awarded at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Direct Health (Preston) on our website at www.cqc.org.uk.
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.