Archived: GreenSquareAccord Stockton on Tees

Direct Healthcare is a service that provides personal care to people in their own home. At the time of inspection approximately 375 people were supported by the service.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Following the previous inspection in March 2019 the provider sent us an action plan. This included information about the actions they had taken to make improvements within the service.

At the last inspection medicines were not managed safely. At this inspection improvements had been made and the service was no longer in breach of the regulation safe care and treatment.

Some people and staff said that communication could be improved. Not all people said they had regular carers and they were not informed if carers were going to be late.

We have recommended that changes made to improve communication, as a result of people and staff feedback during the inspection, should be kept under review to ensure the changes are maintained.

People said they felt safe with the service they received. People and relatives said staff were kind, caring and supportive of people and their families. Comments included, “We get on famously” and “The way the workers engage with my relative is brilliant, making time for them and getting to know them”.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There were opportunities for people, relatives and staff to give their views about the service. Processes were in place to manage and respond to complaints and concerns. The provider undertook a range of audits to check on the quality of care provided.

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

The last rating for this service was requires improvement (published 8 May 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has improved to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Direct Health (Stockton on Tees) on our website at www.cqc.org.uk.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service: We received positive feedback from people regarding the service they received.

The service had made improvements since our last inspection however, peoples medicines records were continually not completed correctly and audits were not identifying these issues to ensure medicines were administered safely.

Audits and systems were not always effective at supporting the manager to monitor the service and making improvements.

There was a quality assurance system in place and people completed surveys several times a year. However, the comments made by people were not always acted on. The service was unable to show how they used people’s views to improve quality of the service.

Risk assessments were in place. Staff knew how to keep people safe and were trained in safeguarding.

People spoke positively about the manager and the wider management team.

Robust recruitment and selection procedures ensured suitable staff were employed.

Staff received appropriate training and support to meet people’s individual needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were supported to have enough to eat and drink.

Appropriate healthcare professionals were involved in people’s care and support as and when this was needed.

There were systems in place for communicating with staff, people and their relatives to ensure they were fully informed via team meetings and phone calls.

People were supported to be independent and their rights were respected. Support was provided in a way that put the people and their preferences first. Information was provided for people in the correct format for them.

More information is in the Detailed Findings section below. For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk

Rating at last inspection: Requires Improvement (report published 2 May 2018) this service has been rated Requires Improvement three times.

Why we inspected: This inspection was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor information we receive about the service. If any concerning information is received, we may inspect sooner.

Enforcement: Please see the Action we told provider to take section towards the end of the report.