Archived: Dome Community Care Services Limited

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.

Dome Community Care Services Limited is an established, family run and small domiciliary care agency. At the time of our inspection, the service provided personal care and support to about 16 people who lived in their own homes. The service covered Barnstaple and the surrounding villages of North Devon. People’s contracted care hours ranged from a minimum of 30 minutes per day to a maximum of 25.5 hours per week. The service employed eleven care workers.

The service has 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.

At the last inspection on October 2015, we asked the provider to take action to improve the management of the service and record keeping. A requirement notice was issued. This action has been completed.

People were very complimentary and happy with the service provided. Comments included, (Care worker) is great … (care worker) is wonderful … they know me better than I know myself” and “I am very contented with my care.” People were supported by enough staff who arrived on time, stayed for the required time and did not miss visits.

Care workers were safely recruited, trained and received supervision in their job roles. They felt valued, included and believed their opinions mattered. Care workers enjoyed working for the service. The workforce was small and static with a low turnover of staff. Regular staff meetings took place to update care workers on important issues.

Staff knew how to recognise the signs of abuse and the correct action to take if they had any concerns. The registered manager knew to notify the local authority safeguarding team and the Care Quality Commission about any concerns about suspected abuse.

When people started to use the service, an assessment of their needs was carried out. Each person had an individual care plan which identified risk assessments. Where needed, risk assessments were developed to help staff keep themselves and people safe. Medicines were given out safely and people were assisted to eat and drink meals of their choices. Care workers monitored people’s health needs and involved health professionals where necessary.

People confirmed staff sought their consent before providing any care and where people lacked capacity, staff demonstrated an understanding of the Mental Capacity Act (MCA) (2005) and how this applied to their practice.

Staff developed positive and meaningful relationships with a team of regular care workers. One person said, “(Care worker) knows me better than I know myself.” People were treated with dignity, respect and privacy. Their independence was maintained and encouraged.

People knew how to raise any concerns or complaints and felt confident to do so. Where concerns were raised these were investigated and the appropriate action taken.

The service was open and inclusive and regular feedback was sought. The service was family run and the registered manager carried out care calls when necessary. People and staff were very positive about the leadership of the service and felt communication was good.

The provider had a range of quality monitoring systems in place which included spot

checks, regular staff meetings and a range of audits. Annual surveys were sent out to gain people’s feedback to improve the service.

The agency provided a service for approximately 40 people, supported by 23 members of staff. People were very complimentary of the service provided. Comments included "it's a very good service" and "they do a very good job". People told us there was very good communication with the office and always found the owners approachable.

People told us they were very happy with their care provided. Comments included "I don't know where I would be without my girls", "all the carers are very good - I know them all" and "they all do their job".

Staff received training in cleanliness and infection control and ensured high standards were maintained in people's homes.

We saw that the agency had an effective complaints procedure which ensured that people's views were listened to and acted upon.

We saw that there were recruitment systems in place to ensure that prospective staff were recruited appropriately.

The agency had a system in place to monitor the quality of care provided. We found that not all records relating to the running of the business were up to date and accurate.