Archived: District Carers Limited

Updated 28 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 15 and 16 June 2017 and was announced. We gave the provider 48 hours notice of the inspection because it provided personal care to people in their own homes so we needed to be sure the registered manager or staff were in the office.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We reviewed information we held about the service, including previous inspection reports and notifications of significant events the provider sent to us. A notification is information about important events which the provider is required to tell the Care Quality Commission about by law.

The inspection was carried out by one inspector.

During our inspection we looked at care plans, risk assessments, incident records and medicines records for six people. We looked at supervision, training and recruitment records for staff and spoke to four staff. We also looked at a range of records relating to the management of the service such as complaints records, quality audits and policies and procedures.

We visited two people in their homes at the time staff were attending. We spoke with six people (or their relative) who received a service from District Carers Limited to ask them their views of the service they received. We sent survey questionnaires to 50 people and to 50 relatives of people to ask them for their views on District Carers Limited. Fifteen surveys were returned by people and three by relatives. We also received a survey questionnaire from a health and social care professional.

We also spoke to a commissioner from the local authority who monitored the provider’s standards of care and purchasing arrangements for care.

Updated 28 July 2017

The inspection took place on 15 and 16 June 2017 and was announced.

District Carers Limited provides personal care to people care in their own homes. At the time of the inspection personal care was provided to 123 people whose ages ranged from 42 to 99 years and had needs such as physical disability, sensory impairment, dementia and frailty due to old age.

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.

At the previous inspection of 3 May 2016 we found the provider had not ensured assessments of risk were adequate to ensure those risks would be mitigated. We made a requirement for this regulation to be met. The provider sent us an action plan of how this was to be addressed and at this inspection we found the regulation was met.

At the previous inspection of 3 May 2016 we recommended the provider put in place a plan for formal supervision of staff as we found staff supervision was inconsistent. At this inspection we found staff supervision was well organised and included observations of staff working with people in their homes to check their competency. Staff told us they felt supported in their work.

Since the last inspection the provider has implemented an IT system whereby each staff member has smart phone which included all the relevant information about their daily work including people’s care plans. Staff completed their daily records on these. The system had a number of benefits to people, staff and the management; for example people and relatives could make comments by directly accessing the records. We noted the system needed to have time to embed as there were a few problems with it. These included staff not being able to fully access the system at times due to poor connectivity. We also noted the IT records did not always have details of people’s medicines. We have made a recommendation regarding the monitoring of care and medicines records.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said the staff provided safe care.

Sufficient numbers of staff were provided so people’s care needs were safely met. People commented that care staff attended at the agreed times. Since the last inspection we received two complaints that staff did not always attend to people at the agreed times. We looked into this during the inspection by asking people about this and by looking at records; these allegations could not be substantiated. We sent surveys to people to ask for their comments about the service; one person and one relative said they did not always get a weekly rota supplied. We spoke to six people or their relatives and these all confirmed they received a weekly rota detailing which staff were coming to see them.

People generally received their medicines safely, although we noted the record system used by the staff did not always detail people’s prescribed medicines which staff needed to administer. This was isolated to two occasions and is referred to in the Well Led section of this report.

Staff were trained in a range of relevant subjects such as moving and handling, dementia awareness, infection control, the Mental Capacity Act 2005 (MCA) and food hygiene. Newly appointed staff received induction training to prepare them for their role.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005. The service had policies and procedures regarding the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff were trained in the MCA and had a good awareness of the legislation. People were consulted and had agreed to the arrangements for their care

People were supported with the preparation of meals where this was needed.

People’s health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed.

Staff had positive working relationships with people. Staff acknowledged people’s rights to privacy and choice. People told us how staff treated them with kindness with compassion. Staff said they treated people in the way they would want a member of their family, or themselves, treated. Staff listened to people and treated people in a way which made them feel valued.

The service had a complaints procedure, and people said any concerns or queries were responded to.

People were involved in discussions about their care and said their needs were met. The staff regularly reviewed people’s care by visiting them in their homes. People told us the staff spent time talking to them after the care tasks were completed which they enjoyed.

People and their relatives’ views were sought as part of the service’s quality assurance process.

The registered manager understood their responsibilities to report specific incidents to the Commission but had not done so for one investigation.

There were a number of systems for checking the safety and effectiveness of the service such as regular audits. Staff said they were supported by the management team.