Archived: GreenSquareAccord Preston

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.

The service was last inspected on 17, 18 and 19 January 2017, when we identified a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe care and treatment. This was because the provider did not have adequate medicine management and administration systems in place. Following the last inspection, we asked the provider to complete an action plan to show us what they would do and by when to improve the key questions of safe and well led to at least good. During this inspection, we found the service was meeting the requirements of the current legislation.

This service is a domiciliary care agency. It provides personal care to 79 people living in their own homes. It provides a service for people living with a dementia, learning disabilities or autistic spectrum disorder, mental health, older people, people who misuse drugs and alcohol, physical disability, sensory impairment, younger adults, older people and children.

The service had a registered manager in post at the time of our inspection. 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.

Improvements had been noted in the safe management of medicines. Medications administration records had been updated to ensure a clear record of medicines administration was kept.

Staff understood the procedure to take if they suspected abuse. Training records confirmed staff had undertaken safeguarding training. Individual and environmental risk assessments had been completed. These advised staff about people’s risks and the measures to take to keep people safe.

Safe recruitment procedures were in place that ensured only staff who were suitable for their role were employed by the service. Training records confirmed staff had received the relevant training to support the effective delivery of care to people who used the service.

Information relating to mental capacity assessments and best interests decisions had been recorded in people’s care files. 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.

Records had information about people’s health care needs and people told us that staff sought medical attention when it was required. People and relatives told us they were happy with the care they received and that they were treated with dignity and respect. Care files contained information about how to support people to be independent as well as reflecting their likes, choices and needs.

Care files were detailed, comprehensive, and reflected people’s individual care needs. Where people required support at the end of their life care files had been completed with information about how to support them responsively.

There was good use of technology to support and enable people’s needs to be met.

An effective system to deal with, investigate and act on complaints was seen. We saw very positive feedback about the service.

We received very positive feedback about the registered manager and the changes they had made since commencing their role. It was clear that she was knowledgeable and had an understanding of the operation and oversight of the service.

Feedback and surveys were undertaken that demonstrated the views of people about the care they received. We saw regular team meetings were taking place. This ensured staff had access to information and updates about the service.

Regular audits and monitoring was taking place that enabled the registered manager to ensure people were receiving a good quality service.