Archived: DLCS Wickford

Updated 14 February 2018

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 over three days, was completed by two inspectors and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service so we needed to be sure that someone would be in. We visited the provider's office on 28 December 2017 and on 29 December2017, we completed two home visits to observe staff providing care and support to people in their own homes. On 2 January 2018, we carried out telephone interviews with people who used the service, their relatives and staff.

Prior to the inspection we reviewed information we held about the service. This included 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. We looked at questionnaires, which had been completed by people who used the service and also looked at statutory notifications that the provider had submitted. Statutory notifications contain information about important events that happen at the service, which the provider is required to send to us by law.

During the inspection we spoke with five people who used the service and two relatives. We spoke with the registered manager, the care manager, the supervisor and five care staff. We also obtained feedback from the quality improvement team of the local authority where the location in based. We reviewed five staff files relating to recruitment and supervision, medication records, staff rotas, policies and procedures. We also looked at compliments and complaints, incident and accident monitoring systems, meeting minutes, training records and surveys undertaken by the service. We looked at six people's care records, which included care plans, risk assessments and daily notes.

Updated 14 February 2018

The inspection, which was announced, took place on 28 December 2017 with follow up visits and phone calls on 29 December 2017 and 2 January 2018. This was the first inspection of the service, which is a domiciliary care agency providing personal care and support to people in their own homes. At the time of inspection, 29 people were using the service.

There was a registered manager in post who was also the registered 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 also managed another service, which had recently been inspected and rated as 'inadequate'. Many of the issues found at the other service had been highlighted as a cause for concern at this service. However, these concerns had been partially mitigated due to the employment of a new management team who were responsible for the day to day running of the service. This factor together with input from the local authority had resulted in improved systems and processes. Consequently, many improvements had already been made and others were planned.

People, staff and relatives were positive about the new management structure and reported progression in the quality and effectiveness of the service. Staff morale had improved and there was a sense of teamwork and a commitment to providing a good service. People's feedback regarding the quality of the service was actively sought and was used constructively to make improvements.

There were sufficient staff employed to meet people's needs. Care staff were not rushed and had time to spend with people. Staff were usually on time for calls and there were no reports of missed visits. However, recruitment processes for care staff required strengthening to ensure staff were recruited safely.

Staff had received training to support people to take their medicines. Improvements were required to ensure more robust assessment and monitoring of staff competence to ensure staff had the skills and knowledge to safely manage people's medicines.

People and their relatives said they felt safe using the service. All staff had completed safeguarding training and there were systems and processes in place to respond to incidents or allegations of abuse.

People had risk assessments in place, which provided detailed guidance to staff on how to minimise risk. Accidents and incidents were recorded by staff and shared with the management team who took the appropriate action to minimise the risks of reoccurrence.

The service provided staff with an induction and training, and supported staff through observations and supervision of their practice to support staff with their learning and development. At the time of inspection staff had yet to receive annual appraisals of their performance however, these had been scheduled for 2018.

People's consent was sought before care and support was provided. Staff and the management team were aware of the requirements of the Mental Capacity Act 2005 (MCA). Assessments of people's capacity and best interest decisions were made appropriately, in consultation with relevant parties.

The service supported people to have enough to eat and drink and helped people to access healthcare services if needed.

Staff were caring, courteous and respectful of people's privacy and dignity. People were listened to and included in decisions about how they would like their care and support delivered. Independence was supported and encouraged.

Improvements had been made to the quality of information held in people's care records. This meant that staff had access to more detailed guidance to enable them to provide care and support that was tailored to each individual and met their needs and preferences.

There were policies and procedures in place for managing complaints. People knew how to complain though lacked awareness about who the registered manager was. People were familiar with the care manager and care supervisor and knew how to contact them to raise any concerns. Records showed that complaints were dealt with appropriately.