Durbia Healthcare Ltd

Durbia Healthcare Ltd is a service providing personal care to people living in their own homes. It provides short and long-term care to people within the community. At the time of our inspection the service supported 7 people including people living with dementia.

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.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support

Since our last inspection the registered manager had made significant improvements to ensure medicine management and administration were done safely and in line with people’s wishes.

The provider worked with other professionals to ensure staff had received training in line with people’s medical conditions such as oxygen therapy and catheter care and their competencies were regularly checked to ensure people were safe.

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

The registered manager had reviewed and updated all care plans and these provided staff with clear guidance on how to provide safe personalised care and how to support people in an emergency situation such as choking.

Staff told us they were supported and had time to spend with people to build trusting relationships and fully understand their needs.

Right Culture

Staff were recruited safely. The registered manager had reviewed all recruitment practices to ensure staff were recruited and inducted into the service safely before working with people.

The provider had introduced a governance system to monitor the quality of the service people received. Although more time was needed to assess the effectiveness these processes, the registered manager was knowledgeable about using the systems and was upskilling other staff to use them.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (12 October 2023) and there were breaches of regulation. We met with the provider to discuss concerns and they completed an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Enforcement

This service has been in Special Measures since 21 November 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.

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 changed from inadequate to good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Durbia Healthcare Ltd is a service providing personal care to people living in their own homes. It provides short and long-term care to people within the community. At the time of our inspection the service supported 14 people including people living with dementia.

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.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support

People did not receive their medicines safely. There was no clear guidance for specialised healthcare tasks such as oxygen therapy and catheter care which placed people at risk of harm.

People were not always supported by staff who were appropriately trained or assessed as being competent.

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

People's care plans and risk assessments did not cover their range of care and support needs. Staff were not guided to support people in line with legislation and good practice which meant people had not been protected from harm.

We received mixed feedback from people in relation to their care. Some people told us they didn’t always feel safe with the care they received. Other people said staff were “kind and compassionate” and “willing to go the extra mile.”

Right Culture:

The provider continued to not follow recruitment legislation and ensure staff deployed had the right employment checks and skills to support people safely.

The service was not well-led. There was no effective governance system in place to monitor the quality of the service provided to people. The provider continued to fail to recognise risks and concerns in relation to health and safety, employment of staff, completing records and medicine management.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (5 February 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

We received concerns in relation to person centred care planning and risks associated with pressure care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 changed from requires improvement to inadequate based on the findings of this inspection.

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 Durbia Healthcare Ltd on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment of people including risk assessments and personalised care planning. Risks were identified in the recruitment of staff and the governance of the service at this inspection.

We imposed conditions on the providers registration to ensure people remained safe whilst the provider worked to make improvements. You can see what action we have asked the provider to take at the end of this full 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.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Durbia Healthcare Limited is registered as a domiciliary care agency providing the regulated activity ‘personal care’ to people who live in their own homes in Nottingham and surrounding areas. At the time of the inspection visit there was one person using the service.

The service was providing support to one person, though since their registration has provided care and support to four people. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and nutrition. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

The service was not always well-led. The provider had not ensured that safe recruitment processes to ensure the safety of people being offered care. The provider had not ensured governance and quality assurance procedures had been fully established in this relatively new service. We found no evidence during our inspection that people had been harmed by these actions.

Staff were trained to support people with their individual needs.

We have made a recommendation that staff knowledge and awareness of subjects is determined following training courses.

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.

People were made aware of the complaints process with information provided when they commenced using the service and knew the process to follow if they had concerns.

The person told us they felt safe when receiving care and support. Staff were aware of measures to take to prevent and control the spread of infection. There was a procedure to record and monitor any accidents/incidents which may occur, none had occurred in the last twelve months.

The person was supported by a small group of staff who knew them well, and so allowing relationships to develop. The person gave positive feedback about the caring staff team.

The person was treated with kindness, respect and without discrimination. Staff involved them in decisions about their care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This is the first rating inspection for this service.

Why we inspected

This was a planned first rating inspection.

We have found the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.