Background to this inspection
Updated
29 March 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 2 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. A new manager had been in post for 5 months and had submitted an application to register. We are currently assessing this application.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 2 March 2023 and ended on 9 March 2023. We visited the location’s office on 2 March 2023.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from the local authorities and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
During the inspection
We spoke with 3 people and 6 relatives about their experience of the care provided. We also spoke with 9 members of staff including the manager, care team manager, care facilitator, training officer and support workers. We reviewed a range of records. This included 4 people's care records and multiple medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
Updated
29 March 2023
About the service
Home Care Direct is a domiciliary care agency providing the regulated activity of personal care to people living in their own homes. People who used the service choose their own team of staff or employed family members as personal assistants. At the time of our inspection 69 people were using the service. The service supports older people, younger adults, people with a learning disability and people who have mental health needs.
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
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support:
People were protected from the risk of abuse and people told us they felt the service was safe. Risks to people and staff had been assessed and people's care plans were regularly reviewed and updated. Staff were recruited safely and there were sufficient numbers of staff with the necessary training to support people safely and meet their needs. Each person using the service was supported by a small team of personal assistants that had been specifically recruited to support them.
People were supported to have maximum choice and 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.
Right Care:
Medicines were managed safely, and we were assured that the provider had sufficient infection, prevention and control measures in place. People received care in a safe and consistent way and people’s care plans detailed information on the monitoring and preventative actions staff were required to take to reduce risks which had been identified.
Right Culture:
People were empowered to make choices and decisions about their care. People were supported to recruit their personal assistants and direct how they received their support. We found people had been involved in creating their care plans which captured the outcomes they wanted to achieve.
The management team understood the importance of monitoring the quality performance of the service and had identified areas for improvement. The manager demonstrated how they used feedback from people and staff, to improve safety and learning across the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 8 November 2018)
Why we inspected
This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part due to concerns received about the training and competency of staff. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained as good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.