Deeper Care Escrick

Updated 30 January 2024

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 1 adult social care senior specialist, an inspector 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 houses and flats.

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 a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 4 December and ended on 11 December 2023. We visited the location’s office on the 4 and 11 December 2023.

What we did before the 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. 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. We used all this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and 10 relatives over the phone to ask them for their views on the care they were receiving. We spoke with 7 members of staff including the registered manager, care co-ordinator and care workers. We reviewed aspects of 7 people’s care records, medicine records and other records relating to the management of the service such as training records and audits.

Updated 30 January 2024

About the service

Deeper Care Escrick is a domiciliary care agency providing personal care to people living in their own homes. The service was supporting 44 people 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

The service predominantly supported older people but also supported one person with a learning disability. 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 Culture

Medicines were not always managed safely. Record keeping and medicines care planning was not sufficiently robust. Safe and appropriate recruitment practices were not always followed. Some audits and checks took place however systems to assess, monitor and improve the service were not sufficiently robust. Some records relating to the management of the service were not present. External agencies had concerns about governance and leadership at the provider. Staff said they felt well supported

Right Support:

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Risks to people’s health and safety were assessed and mitigated. People said they felt safe, and that staff had the right skills and knowledge to care for them. Safeguarding procedures were in place and we saw evidence they had been followed. There were enough staff to ensure people received timely care and support.

Right Care

People told us they received appropriate care from familiar staff at times that suited them. Most people’s care needs were assessed although we found some areas where care plans were not appropriate or in place. Overall, people said they were happy with the care they received and spoke positively about the management team. People said they felt able to raise issues with the provider and felt involved in their care.

Rating at last inspection

The last rating for this service was Good (May 2021).

Why we inspected

We received concerns in relation to recruitment practices, training and risk management. Placements had also been suspended by the local authority as a result of concerns other agencies had identified. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well Led. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Deeper Care Escrick on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to medicines management, recruitment practices, consent and governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.