Archived: DuTee4u Home Healthcare

About the service

DuTee4u Home Healthcare provides personal care within people’s own houses and flats. At the time of our inspection 1 person was using the service.

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

At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

The service was not able to demonstrate how they were meeting underpinning principles of 'Right Support, Right Care, Right Culture.'

Right support: Staff did not support people with their medicines in a safe way to achieve the best possible health outcomes.

Right care: Staff lacked understanding about how to protect people from poor care and abuse. The service did not work well with other agencies.

Right culture: People did not lead inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People did not receive good quality care, support and treatment because staff were not skilled or knowledgeable to meet the person’s needs safely.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 6 June 2022).

At our last inspection we found breaches of the regulations in relation to 9, Person-centred care, 12, Safe care and treatment, 13, Safeguarding service users from abuse and improper treatment, 16, Receiving and acting on complaints, 17, Good governance and 18, Staffing of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider was also in breach of regulation 18 Notification of incidents of the Care Quality Commission (Registration) Regulations 2009.

We told the provider what action they needed to take to ensure the safety of people who used the service. Due to the concerns identified at the inspection the local authority withdrew all, but 1 packages of care. At this inspection, we found the provider remained in breach of regulations.

This service has been in Special Measures since March 2022. During this inspection the provider demonstrated that improvements had not been made. The service remained inadequate and continues to be in special measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We have found evidence that the provider needs to make improvements. Please see Safe, Effective, Caring, Responsive and Well-Led sections of this full report.

The overall rating for this service is 'Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for DuTee4u Home Healthcare Limited on our website at www.cqc.org.uk.

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

People who used Dutee4U Healthcare Limited did not receive a safe, effective, responsive or well led service. The provider was unable to demonstrate the safe and effective running of the service as records were either unavailable, conflicting or disorganised. People shared very mixed experiences of using the service.

Due to the lack of information provided to us, the provider could not demonstrate staff supported people to receive medicines safely and this placed people at risk of harm. Information was not available to support staff to administer safely and records were not accurate. Staff had not received training to administer medicines safely or had their competency checked.

People were not safeguarded from the risk of abuse because the provider could not demonstrate staff were either trained, or informed to recognise the potential signs of abuse. There was no evidence that incidents of potential abuse had been referred to the local authority safeguarding team or investigated adequately by the provider. The provider’s poor documentation meant they could not demonstrate changes had been made to protect people from possible abuse.

People did not always have risks safely managed. Where concerns were identified it was not evident how these were safely reduced or eliminated.

The provider could not demonstrate staff had been recruited safely. Recruitment files seen were incomplete, illegible or inaccurate. We could not be assured who was currently employed by the provider or what checks had been made before employing them.

People did not always receive care and support at times agreed and this affected the quality of care provided and people’s safety.

There was no evidence of people’s capacity to make decisions being assessed by the provider when their needs changed or evidence of how the agency worked effectively with outside agencies, including health care professionals.

People’s private information was not protected in line with data protection legislation.

The provider could not evidence they provided a responsive service. Care was not centred around individual needs, despite care plans being very person centred. Where people had complained about the quality of the care, they received it was not always evident the provider had responded to ensure changes were made as a result.

The service was not well led. The provider had failed to notify appropriate agencies, including CQC of safeguarding concerns and they failed to provide us with information in a timely manner. Some information requested formally following the inspection was not provided. There was no evidence that people had been consulted about the ongoing care they received.

People were not supported to have maximum choice and control of their lives because call times did not always suit the individuals or offer degrees of flexibility. We had no evidence that staff supported people in the least restrictive way possible and sometimes decisions to support people in line with their best interests were not followed and not recorded.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This service was registered with us on 03 February 2020 and this is the first inspection.

Why we inspected

We carried out this inspection after we received concerns from an anonymous source and the local authority safeguarding team about the care and support delivered by the agency.

Please see the action we have told the provider to take at the end of this report.

Enforcement.

We have identified breaches in relation to safe care and treatment, person centred care, safeguarding people from abuse, complaints, good governance (including lack of notifications and management concerns), staffing issues and also the safe recruitment of staff at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.