Background to this inspection
Updated
8 November 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 8 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 at the registered location.
The inspection team consisted of one adult social care 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.
Information had been gathered before the inspection from notifications that had been sent to the Care Quality Commission (CQC). Notifications are when registered providers send us information about certain changes, events or incidents that occur. We also requested feedback from local authorities that contracted services with DCS and D Limited T/A Heritage Healthcare Guisborough. We reviewed information from people who had contacted CQC to make their views known about the service.
During the inspection we spoke with eight people who used the service and seven relatives. We looked at four care plans, ten Medicine Administration Records (MARs) and visit report sheets completed by staff. We spoke with five members of staff including the registered manager. We looked at six staff files which included training and recruitment records.
Updated
8 November 2016
The inspection took place on the 8 August 2016 and was announced. The provider was given notice because the location provides domiciliary care services and we need to be sure that someone would be in. A second day of inspection took place on 1 September 2016 and was announced.
DCS and D Limited T/A Heritage Healthcare Guisborough is a domiciliary care service which provides personal care to people within their own homes. It is based in Guisborough and provides care and support to people in Redcar and East Cleveland. At the time of inspection 104 people used the service.
The service had a registered manager. 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.
There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about the different types of abuse and what actions they would take if they suspected abuse was taking place. Safeguarding alerts had been made when needed.
Risk assessments were in place for people who needed them and were specific to people's needs. Risk assessments had been regularly reviewed and updated when required.
Robust recruitment procedures were in place and appropriate checks had been made before employment commenced.
The registered provider had policies and procedures in place to ensure medicines were managed safely. Accurate records were kept to show when medicines had been administered.
Staff performance was monitored and recorded through a system of regular supervisions and appraisals. Staff had received up to date training to support them to carry out their roles safely and had completed an induction process with the registered provider.
People were supported to maintain their health through access to regular food and drink. Appropriate tools were in place to monitor people's weight and nutritional health. Staff knew how to make referrals to health professionals should anyone using the service become at risk of malnutrition.
Staff demonstrated good knowledge and understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Documentation was available for those people who had Court of Protection orders in place.
Where appropriate, staff supported people to enjoy a good diet and suitable food and nutrition. People were supported to maintain good health and had access to healthcare professionals and services when needed. People made regular visits to their own GP.
People and relatives were actively involved in care planning and decision making, which was evident in signed care plans. Information on advocacy services was available.
Relatives spoke highly of the service and the staff. People said they were treated with dignity and respect.
Care plans detailed people's needs, wishes and preferences and were person centred which meant people received personalised support. Care plans had been reviewed and updated regularly.
The registered provider had a clear procedure for handling complaints which we could see had been followed.
Staff described a positive culture that focused on the people using the service. They felt supported by the management. Staff told us that all managers were approachable and they felt confident that they would deal with any issues raised.
Staff were kept informed about the operation of the service through regular staff meetings. Staff were given the opportunity to recognise and suggest areas for improvement.
Quality assurance systems were in place and completed by the registered manager. Senior management also visited the service regularly to monitor the quality of the service.
Accidents and incidents were monitored to identify any patterns and appropriate actions were taken to reduce the risks.
The registered manager understood their role and responsibilities. Notifications had been submitted to CQC in a timely manner. Notifications are changes, events or incidents the registered provider is legally obliged to send us within the required timescales.