Network Healthcare Professionals Limited - Swindon (DCA) is a domiciliary care agency that provides personal care and support to people living in their own homes. This includes short term support for people who require a period of rehabilitation following illness. However the majority of people using the service required long term support to enable them to continue to live at home.
On the day of our inspection there were 74 people using the service.
There was a registered manager present. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.
People told us they had seen an improvement in the service over the past few months and they felt safe with the care staff. Staff had received training on safeguarding and demonstrated an understanding on how to recognise and respond to abuse. They all understood their responsibility to report any concerns to their management team and were aware of the importance of disclosing concerns about poor practice or abuse.
We found people who lacked mental capacity may be at risk of receiving care that was not meeting their needs and they had not agreed to because staff did not always understand the requirements of the Mental Capacity Act 2005 and its main codes of practice. People’s mental capacity was not always considered when providing them with personal care. However the registered manager was taking action to address this.
People’s risks were managed appropriately and they were involved in making decisions about any risks they may take.
Safe recruitment practices were followed and there were sufficient numbers of suitable staff to keep people safe and meet their needs. One member of staff said, "The office is trying to give us regular clients as this is really important because service users will have more trust with a regular person visiting."
People were supported by staff who had the necessary skills and knowledge to effectively meet their assessed needs. Staff had effective support, induction, supervision, appraisal and training. However we found no evidence they had completed training on the Mental Capacity Act 2005. This meant staff may not be able to identify people who lacked capacity and people may be at risk of receiving care that was not meeting their needs. However the registered manager was taking action to address this.
People told us they were involved in the planning of their care and these were taken into account in the assessment of their needs and the planning of the service. However we found people’s care records were not always accurate to identify the correct level of care, treatment and support given.
The service was caring because people who used the service, their relatives and professionals were positive about the care and support received from staff. Staff treated people with dignity, respect, compassion and kindness when providing care and support.
People felt listened to and were encouraged to make their views known about their care and support and these were respected. People told us the staff listened and acted on what they said.
The service was responsive to people’s needs because most people told us they were given information they needed when they needed it. Some people told us the company had not always informed them if a staff member was off sick and someone else was coming. One member of staff told us, "We are a good team of carers but communication is a problem." However the provider was taking action to ensure all visits were covered and office staff were responsive to changes if a member of staff was running late or not able to work.
People’s views on the quality of the service were taken into account but feedback had not been provided. People received personalised care but it was not always responsive to their needs. Most people told us they did not feel staff had sufficient time to provide them with the care they needed.
People felt confident to express their concerns or complaints about the service they received because concerns and complaints were encouraged and explored and responded to in good time.
All staff we spoke with confirmed they felt well supported in their role, they had opportunities to meet with their manager, and spot checks were carried out to monitor their practice. The registered manager supported learning, encouraged people and staff to raise concerns if they had any, and people told us improvements had been made to the service. Concerns and complaints were used as an opportunity for learning and improvement. Action plans were monitored to ensure they were delivered.
The service had a system to manage and report, incidents, and safeguardings. We saw incidents and safeguardings had been raised and dealt and the commission had been properly notified of relevant events.