Dignity Direct Homecare Limited

Updated 19 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 21 September 2017. One inspector and an expert-by-experience carried out the inspection. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The provider was given 48 hours’ notice to ensure that someone would be available to support us with our inspection.

Before the inspection, we reviewed the information we held about the service including statutory notifications the provider had sent to us about significant events at the service. Statutory notifications include information about important events, which the provider is required to send us by law.

The provider completed a Provider Information Return (PIR). A PIR is a form that requires providers to give some key information about the service, what the service does well and improvements they plan to make. We used this information to plan the inspection.

During the inspection, we spoke with the registered manager, the branch manager, two care workers, a field supervisor, a human resources officer and a consultant retained by the provider for compliance monitoring.

We looked at nine people’s care records, their risk assessments and medicines administration records. We reviewed care workers records including information about recruitment, training, supervision, appraisal reports, duty rosters and care workers’ meetings. We read documents relating to the management of the service that included safeguarding records, accidents and incident reports, complaints and compliments received at the service, policies and procedures and quality assurance records.

We reviewed feedback the service had received from people using the service and their relatives, health and social care professionals and care workers.

After the inspection, we spoke with two people using the service and eight relatives. We received feedback from the local authority commissioner and three health and social care professionals.

Updated 19 October 2017

This announced inspection took place on 21 September 2017. Dignity Direct Homecare Limited provides personal care to people living in their own homes. The service provided other support activities to people using the service such as domestic tasks, which the Care Quality Commission does not regulate. At the time of the inspection, 22 people were using the service.

This is the first comprehensive inspection of the service by the Care Quality Commission (CQC) since registration on 1 February 2016.

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

Care workers knew how to protect people from abuse and understood their responsibility to raise any concerns at the service. The registered manager carried out risk assessments and ensured care workers had guidance about how to provide safe care and support to people. Care workers provided an enabling environment to people for positive risk taking.

People received the support they required to maintain their independence and to reach their full potential. Care workers knew how to support people who displayed behaviours that may challenge the service and others.

People received safe care because care workers underwent robust recruitment procedures and pre-employment checks before they started providing care. The provider ensured there were sufficient numbers of care workers available to meet people's needs.

People received support to take their medicines safely. Care workers were trained and assessed as competent to manage people’s medicines.

People using the service and their relatives said care workers were kind and caring. People were involved in making decisions about their care, and where they were unable to do so, received appropriate support through best interests meetings.

Care workers understood the health needs of people using the service and had sufficient knowledge and skills to deliver their care effectively. People received care from care workers who were supported in their roles. Care workers received regular supervision and appraisal of their performance.

People had an opportunity to provide their views about the service and felt that the provider listened to them. The registered manager responded to people’s feedback and made changes when necessary.

People were treated with dignity and care workers maintained their privacy. The registered manager assessed and reviewed people’s needs regularly. Care workers asked people about how they wanted their care delivered and respected their decisions.

People were supported to eat and drink and to maintain a healthy and balanced diet. Care workers supported people to access healthcare services when required.

People were encouraged to develop and maintain their independence and daily living skills. People received person centred care that was based on their individual needs, preferences and wishes. Care workers supported people to access the community safely and to take part in activities that they enjoyed.

People knew how to raise concerns and make a complaint about the service. The registered manager investigated and resolved complaints in line with the provider’s procedures and timeframes. The provider reviewed procedures and provided additional training to care workers to minimise the recurrence of incidents or complaints at the service.

People and care workers knew the registered manager and described him as approachable and easy to talk to about their welfare. Care workers understood their roles and responsibilities and showed a commitment to support people with their individual needs in a person centred manner. Quality assurances systems were in place and used effectively to monitor the care and support provided to people. The registered manager acted on shortfalls identified and made the necessary improvements.