Direct Approach Care Limited

Direct Approach Care Ltd is a service that provides support with personal care to people living in their own homes. This includes adults living with dementia and mental health conditions.

At the time of our inspection, the service was providing support to seven people.

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 was not always safe. Information about people’s risks was not comprehensive enough. There was no evidence that the service looked for safety related themes or trends. We could not be assured that medicines were always managed safely as audit processes were not in place.

Recruitment processes were not robust enough to ensure staff were safe to work with people. Full employment histories were not always recorded or corroborated.

The safeguarding policy did not reflect current guidance meaning staff may not be up to date with safeguarding practice. We have made a recommendation that the provider updates its policies.

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.

The service was caring, people and their relatives told us staff treated them well.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. Although the service adopted a model of care that maximises people’s choice, control and Independence; people’s care records and governance processes required improvement to better evidence that care was person-centred and promoted people’s dignity, privacy and human rights.

The service was not always responsive. People’s care plans did not contain enough information about their routines and preferences around their care and support, but people and their relatives told us that staff were caring and treated them with respect.

Although the service had not received many complaints, complaints were not recorded and there was little evidence of learning applied to practice within the service. We have made a recommendation about the management of complaints.

The service was not always well-led. Systems for governance and performance management either did not exist or were not reliable or effective.

The registered manager began to address our concerns immediately following the inspection, showing they were responsive and committed to making the required improvements, and that the safety and quality of the service was a priority.

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

Rating at last inspection

This service was registered with us on 19 November 2020 and this is the first inspection.

Why we inspected

As the service has been registered with CQC for over one year, we carried out this comprehensive inspection to award a rating for the service.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

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.