This inspection site visit took place on 07 November 2017. We gave the provider 48 hours’ notice of the inspection visit because the agency is small and the registered manager is often out of the office supporting staff or providing care. We needed to be sure that they would be available.This service 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 and younger disabled adults. Not everyone using Destiny Support Care receives a regulated activity; Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’ such as help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of this inspection 18 people received support with their personal care.
The service had a registered manager in post. 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.
In November 2016 a focussed inspection had been undertaken in response to concerns raised with CQC, and at that time we found that people had not always received their care at the agreed times. Since that inspection the provider had moved offices which had resulted in a change to their registration status and Destiny Support Care now appeared as being ‘newly registered’. However, as the provider and staff team remained the same and continued to provide the same service we have taken the provider’s inspection history into account when we carried out this inspection. At this inspection we reviewed the actions taken by the provider in response to the concerns raised in November 2016 and found that people still felt that their care was sometimes later than agreed. People told us that this did not have any negative impact to their safety or wellbeing and that they understood that staff would sometimes be later than planned due to traffic problems or an unavoidable delay at a previous care visit.
People felt safe receiving their care from staff of Destiny Support Care. Staff had been trained how to safeguard people from avoidable harm and about the potential risks and signs of abuse. Risks to people's health, well-being or safety were assessed and reviewed at regular intervals to take account of people's changing needs and circumstances. There were enough staff available to meet people’s needs and safe recruitment practices were followed to help make sure that staff were suitable for the roles they performed. People received their medicines regularly and were satisfied that their medicines were managed safely. Staff took appropriate actions to protect people from the risk of infection. The management team demonstrated an open culture of learning from complaints, shortfalls identified by routine audits and other relevant events.
People received care from a staff team who knew them well and received the training and support to meet their needs. 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. Staff provided support for some people to have food and drink of their choice. Staff supported people to access healthcare appointments if needed.
People, and their relatives were satisfied with the staff that provided people’s care. Staff respected people’s dignity and encouraged them to remain as independent as possible. People received care, as much as possible, from the same care staff or team of care staff members. People's care records were stored in a lockable office in order to help maintain their dignity and confidentiality. People were regularly asked about their care and support needs so that their care could be tailored to their changing needs.
People's care plans were sufficiently detailed to be able to guide staff to provide their individual care needs. People's care needs were reviewed regularly to help ensure the care provided continued to meet people's needs. Care was arranged around people’s wishes and needs. Concerns and complaints raised by people who used the service or their relatives were robustly investigated and resolved and the management team worked closely with complainants to help make sure that they were satisfied with the outcomes.
People felt that the registered manager was approachable with any concerns. All the people we spoke with told us that they felt Destiny Support Care was well managed, well run and said that they would recommend the service to other people. The registered manager demonstrated a good knowledge of the staff they employed and people who used the service. Staff told us that the management team was approachable, supportive and that they could talk to them at any time. There was a programme of checks undertaken routinely to help ensure that the service provided for people was safe. People received regular satisfaction surveys to complete to provide feedback about the service they received.