Derbyshire Care Services and Key 2 Care Leicestershire

Updated 22 January 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors, two assistant inspectors and two experts 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.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service one weeks’ notice. This was because we asked the registered manager to arrange for us to be able to contact people using the service, their relatives and staff as part of the inspection. We also needed to check the current Covid-19 status for staff who worked at the office where we would be inspecting.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We spoke with the registered manager about medicines management concerns and they told us they would put an action plan in place to address these. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with the registered manager and care coordinator. We made phone calls to 12 care staff on 29 and 30 September 2020. We made phone calls to 14 people who used the service and 12 relatives on 29 September 2020. We reviewed the action plan for medicines management implemented by the registered manager.

We reviewed a range of records. This included three people’s care records and medicines records. We looked at four staff files in relation to their recruitment and supervision. A variety of records relating to the management of the service, including audits and policies were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 22 January 2021

About the service

Derbyshire Care Services HQ is a domiciliary care service providing support for up to 420 people, the majority of whom receive personal care. The service provides care to people living in their own homes in Derby and some parts of south Derbyshire.

People’s experience of using this service and what we found

Medicines management required further improvements to help ensure people received their medicines consistently. Risk assessments did not always provide enough detail.

Staff had been retrained and had their competencies to safely administer medicines re-checked. Risks in people’s homes were assessed to help ensure people received safe care. Staff understood what actions to take to help keep people safe from any risks associated with their healthcare conditions. People felt safe with the care they received. Staff understood what actions to take to help prevent abuse or avoidable harm to a person. Recruitment processes checked to ensure staff were suitable to provide care. There were enough staff to provide safe care, however some people commented on calls being late. Processes were in place to prevent and control the risks from infection, including those from covid-19. The provider took the opportunity to learn from when things went wrong.

Some improvements were needed to governance arrangements including records and audits, this was underway. The service was operated with an open and transparent management style. People’s views were sought with a view to improving care. People received care that helped them achieve good outcomes. The provider was in the process of implementing a new electronic care records system and they were expecting this to improve care records and audit effectiveness. The service worked in partnership with other agencies involved in people’s care to help ensure good care outcomes.

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. (Report published 21 February 2020).

Why we inspected

We completed this focused inspection due to a number of safeguarding concerns over the management of risks associated with people’s health conditions, including risks from medicines.

This report only covers our findings in relation to the Key Questions Safe and Well-Led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has deteriorated to requires improvement. This is based on the findings at this inspection.

Follow up

We will return to inspect as per our re-inspection programme. If we receive any concerning information we may inspect sooner.