We carried out a review of the data available to us about Home Care Direct on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Home Care Direct, you can give feedback on this service.
Home Care Direct is a domiciliary care agency providing the regulated activity of personal care to people living in their own homes. People who used the service choose their own team of staff or employed family members as personal assistants. At the time of our inspection 69 people were using the service. The service supports older people, younger adults, people with a learning disability and people who have mental health needs.
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
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support:
People were protected from the risk of abuse and people told us they felt the service was safe. Risks to people and staff had been assessed and people's care plans were regularly reviewed and updated. Staff were recruited safely and there were sufficient numbers of staff with the necessary training to support people safely and meet their needs. Each person using the service was supported by a small team of personal assistants that had been specifically recruited to support 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.
Right Care:
Medicines were managed safely, and we were assured that the provider had sufficient infection, prevention and control measures in place. People received care in a safe and consistent way and people’s care plans detailed information on the monitoring and preventative actions staff were required to take to reduce risks which had been identified.
Right Culture:
People were empowered to make choices and decisions about their care. People were supported to recruit their personal assistants and direct how they received their support. We found people had been involved in creating their care plans which captured the outcomes they wanted to achieve.
The management team understood the importance of monitoring the quality performance of the service and had identified areas for improvement. The manager demonstrated how they used feedback from people and staff, to improve safety and learning across the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 8 November 2018)
Why we inspected
This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part due to concerns received about the training and competency of staff. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained as good based on the findings of this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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.
People felt safe and personal assistants were trained in safeguarding adults and understood how to protect people from abuse. Where risks had been identified, measures were taken to reduce or prevent potential risks to people. People had support to take their medicines at the right time and personal assistants knew how to act if medicines were missed. Recruitment checks were carried out prior to assistants starting work to ensure their suitability to work with people who used the service. The registered manager and team of staff reflected on how the service was managed to ensure lessons could be learnt and any improvements made.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were actively involved in making choices and decisions about how they wanted to live their lives. Personal assistants sought people’s consent before they provided care and support and people were involved in the planning and reviewing of their care. People were treated with dignity and respect by personal assistants who understood the importance of this. Where assistance was required, people received support to prepare and eat their meals and had access to food and drink between support visits.
People had been involved with developing their care plans and felt these reflected their support. They were positive about the relationships they had formed with their personal assistants and the care they received. Personal assistants were respectful and protected and maintained their privacy and dignity when offering care and support. Staff members understood the need to ensure all information was respected and maintained confidentially. People's care records were kept securely in the provider's office to help ensure that they could only be accessed by people authorised to do so.
The personal assistants were kind and caring and had the right skills and experience to provide the care and support people required. People benefitted from receiving a service from personal assistants who were happy in their work and supported. There were enough suitably trained personal assistants to deliver safe and effective care to people and they received supervision to ensure they remained competent in their role.
People’s care was reviewed with them and family members to ensure it continued to reflect their personal care needs. People knew how to make a complaint if they needed to. People were confident they could raise any concerns or issues with staff in the office and the registered manager, knowing they would be listened to and acted on.
Quality assurance systems had been developed to monitor how the service was delivered and people were able to comment on the quality of the service. The provider worked with other health and social care professionals to ensure people received an individual service that was designed to meet their needs.