Background to this inspection
Updated
11 September 2021
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector and one Expert by Experience who spoke with people on the telephone. 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. The service was also registered for nursing care; however, they were not providing nursing care to people at the time of the inspection.
The service had a manager registered with the Care Quality Commission. This means the provider and manager were legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave a short period notice of the inspection. We needed to be sure the provider or registered manager would be in the office to support the inspection. We also needed to arrange to speak with people and for documents to be sent to us.
Inspection activity started on 10 August 2021 and ended on 13 August 2021. We visited the office location on 10 August 2021 and 11 August 2021.
What we did before the inspection
We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We received one feedback. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service and four relatives about their experience of the care provided. We spoke with six members of staff including the office manager, provider, administrator and care workers.
We reviewed a range of records. This included three people’s care records. We reviewed medicines records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
Updated
11 September 2021
About the service
Prudent Domiciliary Care Limited is a domiciliary care agency providing personal care and support for people in their own homes. The agency provides care and support for people in the Kent area. At the time of our inspection, 13 people were receiving personal care from the agency
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
Feedback from people and relatives were mixed. One person said, “I have a group of about three carers, and they come sometime between 10am and 12noon each day. They came at 2pm last Sunday and nobody rang to tell me they were running late. Fortunately, my brother came to visit so he helped me.” Another person said, “I Can’t fault the carers and anything they do for me they are so friendly and yes they are well trained to do everything I need.”
People told us about times when calls were late, missed calls and people are not sure of what time their calls are supposed to be. The provider had been taking actions to rectify this. However, these had not been effective in ensuring people’s needs were met in a timely and safe manner.
The service had a system in place to assess, monitor and improve the quality and safety of the services provided. However, this failed to address concerns raised.
Staff told us there was an open culture where they were kept informed about any changes to their role. Staff and people told us the provider was approachable and would listen them.
Care plans contained detailed risk assessments. Risk to people’s health and wellbeing were addressed and mitigated. Environmental risk assessments were also in place, which identified and reduced any environmental risks to people and staff.
Robust recruitment processes were in place. This prevented unsuitable staff from working with vulnerable adults. Staff were skilled in carrying out their role. The provider ensured staff were appropriately trained.
People told us they felt at ease with staff. People were cared for by staff who treated them with dignity and respect. Staff were committed to providing person centred care and respected people’s individual preferences.
People’s needs were assessed prior to receiving a service including their protected characteristics under the Equalities Act 2010.
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. Staff had the information they needed to support people to make choices.
The service worked in partnership with other organisations to improve outcomes for people where this was needed. Spot checks were undertaken to ensure staff were following correct procedures and practices.
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)
This service was registered with us on 03 December 2020 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about recruitment, staff training, staff practices, staff working long hours, no travel time between calls, people are not receiving care at the time they should and that staff are discouraged from raising concerns to external agencies. A decision was made for us to inspect and examine those risks.
We have found evidence that the provider needs to make improvements. Please see Safe and Well Led sections of this full report.
The provider has taken action to mitigate the risks. However, these had not been effective.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Prudent Domiciliary Care Limited on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.