Archived: Dee's Domiciliary Care Services Limited

Updated 31 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This 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 was an announced inspection which took place over two days on 24 and 25 November 2016. The inspection team consisted of a lead inspector, a second inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who has used this type of service. The lead inspector visited the organisation’s office and spent time speaking with the registered manager and staff. The second inspector visited people in their homes. The expert by experience undertook phone calls to people using the service.

Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification is where the provider tells us about important issues and events which have happened at the service. The provider completed a provider information return. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help us decide what areas to focus on during our inspection. Prior to the inspection we also sent out questionnaires to 37 people, asking them for their views about aspects of the service they received. Sixteen questionnaires were returned and some of the feedback from these is also shared in this report.

During the inspection we spoke nine people who used the service by telephone. We also visited five people in their homes and spoke with them about their care and support. We spoke with the registered manager, the performance and quality (PQA) manager, the office manager, a client liaison support officer and a call co-ordinator. We also spoke with 10 care workers. We reviewed the care records of ten people and four staff and other records relating to the management of the service such as audits, incidents, policies and staff rotas.

Following the inspection we sought feedback from three health and social care professionals and asked their views about the care provided by the service.

The service was last inspected in July 2015 when we rated the service as requires improvement. We also found that the legal requirements were not being met in relation to consent and to the provision of person centred care.

Updated 31 December 2016

This inspection took place on the 24 and 25 November 2016 and was announced. The provider was given 48 hours’ notice because the location is a domiciliary care service and so we needed to be sure that key staff would be available at the office.

Dee’s Domiciliary Care Services provides personal care, respite and domestic services to people in their own homes, some of whom are living with dementia or have complex health needs. The service operates mainly in the eastern part of the City of Southampton, where it is a preferred provider under the local authorities domiciliary care framework. The service also provides care to some people living in Hedge End, and the Bursledon, Netley and Hamble areas of Hampshire. There were 80 people using the service at the time of our inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People did not always have a care plan which provided detailed information about their needs and supported staff to deliver responsive care. The legal requirements of the Mental Capacity Act (MCA) 2005 were not being fully met. The provider had been asked to make improvements with regards to both these areas at our last inspection in July 2015. The required improvements had not been made.

Some risk assessments needed to be more robust and include more detailed guidance about how the identified risks were to be managed. More robust systems were needed to ensure that medicines were managed safely.

The provider had not notified CQC about significant events that had occurred within the service.

People told us the reliability of the service, particularly at weekends, needed to improve. Communication was sometimes poor. This impacted upon the confidence people had in the service and its leadership.

Staff had received training in safeguarding adults and had an understanding of the signs of abuse and neglect. Where concerns had been expressed about the care provided by Dee’s Domiciliary, their senior staff were working effectively with the local authority to investigate and learn from these.

The induction for new staff was limited and was not mapped to nationally recognised standards. Staff did not receive regular supervision. This is important as it helps to ensure staff receive the guidance required to develop their skills and understand their role and responsibilities.

Improvements were being made to ensure that there were sufficient numbers of staff deployed to meet people’s needs. Recruitment practices were safe and the required checks had been completed before new staff members started work.

People were happy with the support they received to eat and drink and staff were able to describe to us the importance of protecting people from the risk of poor nutrition or hydration. Most people felt staff helped them to stay healthy and monitored their wellbeing.

People were treated with kindness. They felt that their privacy and dignity was respected. People felt at ease with their regular care workers who had developed positive caring relationships with them.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have asked the provider to take at the back of this report.