Background to this inspection
Updated
10 October 2019
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
One inspector carried out this inspection.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing. There were 17 people using the service at the time of inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced.
We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.
Inspection activity started on 28 July 2019 and ended on 6 September. We visited the office location on 30 July 2019 and 4 September 2019 to give feedback.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included the last inspection report, statutory notifications received and other information we held.
Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us to give some key information about the service, what it 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.
During the inspection
At inspection, we spoke with the nominated individual, the registered manager and one care senior care worker. The nominated individual is responsible for supervising the management of the service on behalf of the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
Following the office visit, we spoke by telephone with all 17 people, or their relatives, receiving care and support to gain their experiences of the service. We spoke with a further 4 care workers.
Two people gave consent to us visiting them in their own homes which we did on 4 September 2019.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
10 October 2019
About the service
Dome Community Care Service Limited provide care and support to people in their own homes in the Barnstaple areas of North Devon. 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. Everyone who used the service at the time of inspection received personal care.
People’s experience of using this service and what we found
People were at the heart of Dome Care and the service was flexible to meet their personal needs. People gave extremely positive views and overwhelmingly praised the service. Comments included, “They are so flexible and fit in with what I want … they provide an exceptional service” and “I will never find an agency as good as this one … they are perfect.”
The service was a small family run business. The registered manager and nominated individual treated people as their extended family and cared for them as such. There was an open and inclusive culture. Both visited people in the community, either to deliver care or just to ‘drop in for a chat’. They knew each person well and effective communications had built up.
Staff were very kind, caring and compassionate to people. People told us how staff regularly ‘went over and above’ what was expected of them. Comments included, “Staff are always kind and caring to me, I am well and truly satisfied”, “I can’t praise them highly enough” and “Staff go above and beyond all the time.”
Acts of kindness were embedded in staff practice and staff regularly undertook extra tasks for people. Staff always stayed the time allocated and always ensured people had everything they needed before leaving the visit.
People were treated with respect, dignity and empathy at all times. Staff were very knowledgeable about people’s individual needs and choices. Close and meaningful relationships had been developed between staff and people and this was evident by all the positive comments received. Staff spoke about people with respect and kindness.
Staff were safely recruited, well trained and received supervision. There was a small staff team and a low turnover of staff. Most of the staff team had worked for the service for several years.
Staff involved people’s families in the person’s care which relatives appreciated and spoke of the positive impact this had had on their lives too. People were supported to attend GP or hospital appointments.
Dome care was extremely responsive to people’s changing and short notice changes. They supported people at times of crisis and helped as much as possible.
People received their medicines safely, were supported to eat nutritious meals and kept safe by staff who had a good understanding of what abuse was.
People were protected from risks because these had been assessed and recorded. Staff undertook good infection control procedures.
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 registered manager maintained an oversight of the service and continually sought to improve practice. They wished to remain small. This allowed them to know each person and their families well. They delivered a quality-based service with had positive impacts and experiences for people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 1 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.