We carried out a review of the data available to us about Duke Street on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Duke Street, you can give feedback on this service.
This inspection took place on 3 January 2018 and was announced. The provider was given 48 hours’ notice of our inspection, because we needed to make sure someone would be in the location office when we visited. At the time of our inspection, the service supported approximately 13 mainly older people.
Not everyone using Duke Street receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
At the last inspection we rated the service good. At this inspection the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service had a registered manager. 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.
The service provided safe care to people. Staff had received training in safeguarding adults and understood their responsibilities to identify and report any concerns. The provider had robust procedures to ensure effective recruitment of staff. There were sufficient staff employed to meet people's needs.
Assessments and care plans were person centred and provided guidance to staff on how to safely meet people's needs. Medicines were managed safely and people received their medicines as prescribed to people who needed this support.
People received effective care from staff who had the skills and knowledge to support them. Peoples health needs were promoted and when required support was provided with nutrition and hydration.
People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice
The service provided support in a caring way. People benefited from caring relationships with staff who treated them with dignity and respect. People were involved in their care and supported to remain independent.
People received personalised care by staff who understood people's individual needs and preferences. People's changing needs were responded to appropriately and their preferences and choices respected.
The service continued to be well led by a registered manager and provider. Systems were in place for checking the quality of the service using audits and satisfaction surveys.
Further information is in the detailed findings below.
We undertook this announced inspection on the 8 December 2015. At the previous inspection, which took place on 10 September 2014 the service met all of the regulations that we assessed.
Duke Street domiciliary care agency provides personal care in people's own homes, through a short term assessment and re-ablement team (START). This offers short term support to people to regain their independence after an accident, ill health, or disability. The service is available to people who live in Settle and the surrounding villages in the Dales. At the time of this inspection the agency was providing support for 21people. Duke Street Domiciliary Care Agency employs 31 support staff a homecare manager and also a registered manager.
There was a registered manager at this service. 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.
People told us they felt safe when receiving support from staff. People told us how they valued the service they had received from the START team, as most people experienced short term domiciliary care for around 6 weeks usually after a hospital stay.
The service recruited staff in a safe way making sure all necessary background checks had been carried out. Staff had a good understanding of safeguarding procedures and how to protect people from harm. There were risk assessments in place to identify risks due to people’s health or mobility and to make sure these were minimised without intruding on people’s privacy and independence. There were records that showed staff received the training they needed to keep people safe.
Care plans were comprehensive and had associated risk assessments. Some of the people who used the service were supported with taking their prescribed medication and staff told us they were trained and competent to assist people with this.
People were protected because staff at the agency were aware of and followed the principles of the Mental Capacity Act 2005.
Staff were supported and trained to help them deliver effective care. They had access to mandatory training, and staff told us they were supported to attend other courses which would be of benefit to their personal development and people who used the service.
Staff had regular contact with other healthcare professionals at the appropriate time to help monitor and maintain people’s health and wellbeing. People were provided with care and support according to their assessed need.
People who used the service were positive in their comments about staff and told us they were ‘all excellent’ and that staff supported people to maintain their independence, which enabled them to remain in their own home.
Systems and processes were in place to monitor the service and make improvements where they could. This included internal audits and regular contact with people using the service, to check they were satisfied with their care packages. Policies and procedures had been updated to ensure they were in line with current legislation.
The service was well-led. The management team were committed to providing a good quality service. Systems and processes were in place to monitor the service and make improvements where they could. This included internal audits and regular contact with people using the service, to check they were satisfied with their care packages.
There were good auditing and monitoring systems in place to identify where improvements were required and the service had an action plan to address these.
As part of this inspection we looked at records for six people who use the agency and records relating to the management of the service. We spoke with five people who use the service and two representatives by telephone. We also spoke with six members of staff, including senior staff.
Below is a summary of what we found. The summary describes what people who use the service and staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
There were systems in place to monitor staffing levels and organise rotas for home visits. This meant that carers usually ran to time with visits. Everyone we spoke with who used the service and staff confirmed that arrangements for staffing were well organised. This ensured that people were safe because their calls were carried out in a timely manner and they knew when to expect a visit.
We asked those we spoke with whether they felt safe when being supported by staff. One person told us, 'I always feel safe; I am in safe hands for sure.' Another person told us, 'I feel safe as I know the carers very well.'
We saw evidence of people consenting to their care plans and people told us they had been involved in developing them. Staff had a good understanding of the importance of getting people's consent before carrying out care. The service had policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were assessed prior to a service commencing and on an on-going basis, this helped to ensure their rights were protected.
We found there were systems in place to make sure people who used the service received their medication correctly and as prescribed.
Is the service effective?
People had an individual file, which contained a care plan and any associated risk assessments that were required. We saw care plans contained detailed information about people's needs and how they preferred their care to be delivered. The risk assessments were also sufficient to identify and minimise risks.
We spoke with people who used the service and they told us the support they received was meeting their needs extremely well. Comments included; 'They [the carers] are very helpful and friendly.' And, 'They are a huge help to me and because of them I can stay at home where I want to be.' When we spoke with staff they told us they thought they provided a good service which was organised in a way that meant they worked effectively.
Is the service caring?
All the staff we spoke with were enthusiastic about providing caring and effective support. When we spoke with people who used the service they told us that staff were 'cheerful' 'committed' and 'more than helpful.' They also told us that staff were very good at respecting their privacy and dignity when providing support. Comments made to us included, 'The girls are very supportive, friendly and respectful. They definitely maintain my dignity when bathing or dressing me.'
Is the service responsive?
There were audit systems in place regarding health and safety, documentation and people's satisfaction with the service they received. This was designed to allow management to monitor the quality of service. There were also systems in place for highlighting issues and learning from accidents and incidents.
People told us they knew how to make a complaint and would feel comfortable in doing so. None of the people we spoke with had had reason to complain about any aspect of the service.
Is the service well-led?
There was a consistent permanent staff team and no staff vacancies at the time of our inspection. The majority of the staff team had worked at the agency for over four years. There were low levels of sickness and absence. The staff we spoke with told us that the manager was approachable and as eager as they were to provide an effective quality service.
People who used the service told us they were satisfied with the care and support being provided. They made comments like, "All the staff who help me are very good, they know what they are doing.' And 'Absolutely smashing all of them. They always stop and have a chat with me, and I know they are very busy, I really appreciate that.'
People also told us staff supported them in a respectful and dignified manner. They felt that staff worked hard to ensure they were supported in line with their wishes.
We looked at people's care records. We found that records were consistent, accurate and up to date. We also saw that the service delivered the care in a person centred way which meant that they included people in decision making throughout their care.
We saw that staff had the right training in place and were well supported to do their job.
We also confirmed that there was effective leadership and good systems in place to regularly monitor the care, treatment and support people received.