Archived: Direct Care Works Ltd

Updated 5 October 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 was planned to check 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 August 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

The inspection was carried out by one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we asked the provider to complete 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 improvements they plan to make. The provider completed and returned the form.

We checked information that we held about the service and the provider. This included statutory notifications. A notification is information about important events which the service is required to send us by law.

During our inspection we spoke with one person who used the service and six relatives of people who used the service. We also spoke with two care workers and the providers of the service.

We reviewed a range of records about people's care and how the service was managed. These included care records for three people, medicine administration record (MAR) sheets, four staff training and employment records, quality assurance audits, incident reports and records relating to the management of the service.

This was the first inspection of this service since its location changed in October 2015.

Updated 5 October 2016

This inspection took place on 15 August 2016 and was announced. This meant we gave the provider 48 hours' notice of our visit because we wanted to make sure someone would be in the office to talk with us.

Direct Care Works Ltd is registered with the Care Quality Commission to provide personal care to people who wish to remain independent in their own homes. The service provides support and care for people in and around Leicester and provides for people living with a range of needs, including mental health and physical disabilities. At the time of our inspection there were nine people using the regulated activity.

The service is required to have a registered manager. At the time of our inspection, there was no registered manager in post and the day-to-day operations were being managed by the provider. 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. The provider was in the process of recruiting to the post of Registered Manager.

There were good systems in place to keep people safe. Assessments of risk had been undertaken and there was clear guidance for staff on what action to take in order to mitigate risks to people. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. People were supported to take their medicines as prescribed.

People were supported by the number of staff identified as necessary in their care plans to keep them safe. There were robust recruitment and induction processes in place to ensure new members of staff were suitable to support people.

Staff had the skills and knowledge to ensure people received care in line with their care plans and best practice. There were regular formal and informal supervisions and observations of working practices which supported staff to meet people's care needs effectively.

People were supported to maintain good health and had assistance to access health care services when needed.

The provider and staff we spoke with were knowledgeable of and acted in line with the requirements of the Mental Capacity Act 2005. Staff sought consent from people before providing personal care.

People and their relatives told us staff were respectful and caring and supported them to maintain their privacy and dignity. People were offered choices and were involved in their own care. Staff were able to give examples how they supported people to maintain their independence and provided care that was never rushed but at the pace of the individual person.

People told us they were involved in their care plans and were consulted about their care to ensure wishes and preferences were met. Care plans and assessments contained relevant information for staff to help them provide the personalised care people required. People were given opportunities to share their views and opinions about the quality of care they received. People felt confident to complain and information was available in different formats to support people to express concerns and complaints.

People and their relatives were confident in how the service was led and the abilities of the management team. The provider and managers were committed to providing quality care and support for people. Staff had regular opportunities to feedback about people's care and were encouraged to share ideas with managers.

The provider, who was also the Operations Manager, undertook regular monitoring to evaluate the quality of the service. This included spot checks on staff working practices, audits of care records and review and analysis of key information such as complaints and incidents. We found that the Operations Manager was not always aware of their legal responsibilities. Although they had notified and worked with other agencies, such as local authorities, they had not notified Care Quality Commission of significant incidents in a timely manner.