Archived: Cathedral Gate Domiciliary Care Services

Updated 24 July 2018

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.

The inspection took place on 23 May and 1 June 2018, and was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to be sure that someone would be available at the office.

This inspection was undertaken by one 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.

Before our inspection visit, we reviewed the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports and notifications we had received. Services tell us about important events relating to the care they provide using a notification.

In order to gain feedback about Cathedral Gate Domiciliary Care Services, we spoke to eight people who used the service, a relative and four staff on the telephone. We spoke with the registered manager and two staff in the office. We looked at people's care records and documentation in relation to the management of the agency. This included quality auditing processes and staff training and recruitment records. After the inspection, we contacted 12 health and social care professionals for their views of the service. Five health and social care professionals responded.

Updated 24 July 2018

This inspection took place on 23 May and 1 June 2018 and was announced.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. Not everyone using Cathedral Gate Domiciliary Care Services receives regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, and help with tasks related to personal hygiene and eating. For people who receive a regulated activity, we also take into account any wider social care provided.

The last inspection took place on 16 December 2016 and 12 and 13 January 2017. We identified two breaches in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because risks were not always identified and sufficiently addressed, medication profiles were not in place and records of topical ointments and creams were not maintained. In addition, auditing of the service was not fully effective, and findings were not used to improve the service. We also made a recommendation to develop a more person centred approach to care planning.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when, to improve the key questions of whether the service was safe, effective, responsive and well led to at least good. At this inspection, improvements had been made to all areas, although further work was needed in relation to the well led domain.

There was a registered manager in post. 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. The registered manager was not available on the first day of the inspection, but was present on the second day.

Following the last inspection, the registered manager had researched quality auditing systems and the formats available. However, further work was needed to implement these and to ensure an overview of different areas of the service.

Improvements had been made to people’s care plans. The information reflected people’s needs, the support they required and their interests. The content of the plans was easy to read, detailed and person centred.

A new format had been introduced for staff to document the administration of people’s medicines. The information gave clear instructions which minimised the risk of error.

People were happy with the service they received. They said they were supported by a consistent team of staff who knew them well. People told us staff generally arrived on time and there were no concerns about staff not arriving to support them. They told us staff asked for their consent and always did what was asked on them.

People were complimentary about the staff. Staff were well supported and received a range of training to help them to undertake their role more effectively. Safe recruitment practice was followed and new staff received a thorough induction before working with people on their own. There were enough staff to support people.

There was a strong culture that was built on kindness and compassion. Core values, such as dignity and respect, were an integral part of service provision.

People told us they felt safe. Staff were aware of their responsibilities to identify and report a suspicion or allegation of abuse.

People were supported with meal preparation and encouraged to drink sufficient amounts. They were supported with their health care needs as required. The agency had built good relationships with local services.

People knew how to make a complaint and were encouraged to give their views of the service. Any requests or suggestions were addressed although there was not an overview, which could be used to develop the service further.

There was a clear vision for the development of the service. This included a new area of specialist support and greater networking. There were plans to develop the size of the agency, using a planned and targeted approach. New care packages were only accepted if the service had the skills and capacity to support the person safely and effectively.

We made one recommendation for the provider to implement their research into quality auditing systems and to ensure an overview of different areas of the service.