Archived: Quantum Domiciliary Care Limited

We considered all of the evidence that we had gathered under the regulations that we inspected. Below is a summary of what we found. The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

We saw that people had an assessment of their needs and associated risks. A plan of care was completed which enabled staff to offer care and support to people in a safe way. Staff told us and records sampled showed that they received regular training and support to enable them to deliver care and support safely.

Everyone that we spoke with said that they felt happy with their care staff and safe with the staff that supported them. One relative we spoke with said, 'They ring me if they have any worries about my relative. I can trust them and rely on them. They always leave their walking frame near and check they have their pendant alarm on.'

Records sampled showed and all people spoken with told us, that they had received their medicines as prescribed by their doctor to ensure their health needs were met.

The registered manager told us that some new staff had commenced employment since our last inspection. We saw that staff files contained the required pre-employment checks. This meant that the provider took steps to ensure that people employed were suitable to work with vulnerable adults.

The Care Quality Commission (CQC) monitors the implementation of the Deprivation of Liberty Safeguards (DoLS) when applied to care homes. We spoke to the provider about the court ruling regarding DoLS in domiciliary care services. The registered manager told us that no one currently using their service was subjected to a Deprivation of liberty safeguard. The registered manager also told us and records showed that all staff had received DoLS training which ensured they had information about their responsibilities.

Is the care effective?

People spoken with told us and records sampled showed that they had been involved in an assessment of their needs and were able to tell staff what support they needed. This meant that people could influence the care they received.

We saw that people's cultural, dietary and linguistic needs were met by staff with the appropriate skills. For example, we saw that people were supported by care staff that were matched to their needs and understood the way they communicated their needs or cultural requirements.

We asked staff about the help they provided to people. All staff spoken with were able to give us good detail about the support they provided. One member of staff said, 'I always give people a choice of what to wear and what to eat or drink. I help them to do things that they can for themselves so that they can keep some independence. That's important.' People told us that they were supported by the same staff on most care calls but did not always know in advance who was coming. Records sampled and our discussions with the registered manager confirmed that calls were made to people if any last minute changes were made to their carer because of an emergency. This ensured that people felt confident that they that they would always receive continuity of care from staff they felt comfortable with who understood their needs.

Is the service caring?

People told us they were happy with the care they received and that staff treated them with respect. We saw that respectful language was used when whenever staff described the identified support needs of people and the level of care delivered in their care records. We saw from daily records sampled that where staff had concerns about people's health, additional visits were made and advice sought from healthcare professionals. We saw that people's involvement with other healthcare professionals was recorded and their advice was followed. One person told us, 'The staff are top class. They really help my relative. Nothing is too much trouble. They are wonderful to us.'

Is the service responsive?

People told us that staff did what they wanted them to do. They told us that if their care workers were going to be late they were kept informed in the main either by the care staff or the office. One person told us, 'If my carer is going to be late they usually let me know.' A relative told us, 'They come when they should and they listen to what my relative has to say; they treat them well and with great kindness. I know we can rely on them.'

Records sampled showed that there were systems in place to gather the views of people so that the service developed and took into consideration views of staff and people who received a service.

There was a system in place to handle concerns and complaints. We saw records that showed four complaints had been received by the provider since our last inspection in November 2013. We saw that these had been investigated sensitively in a timely way and had been resolved to people's satisfaction.

All of the people spoken with told us that they were aware of who they should contact if they were unhappy about the service provided. They all told us they were happy with the service and had not needed to make any complaints recently as call timings had improved greatly since 2013.

Is the service well led?

We saw that the service had a staffing structure that enabled the service to be managed appropriately. This included a manager that we; CQC have registered to be responsible for the running of the service. People were consulted about the quality of service they received. Comments and suggestions were analysed to identify where improvements were needed.

At our last inspection we identified that the systems that audited the quality of recording medication administration had failed to identify shortfalls and gaps in record keeping. Records sampled at this inspection showed that quality assurance systems had been improved and records sampled showed that audits now identified problems or opportunities to identify record keeping errors and change things for the better and these were addressed promptly. As a result the quality of the service was continuously improving.

Staff told us they were clear about their roles and responsibilities and received regular newsletters and had frequent staff meetings. Staff had a good understanding of the service and of quality assurance processes that were in place. This helped to ensure that people received a good quality service at all times.

Spot checks on staff skills and work practices took place regularly. Findings were detailed and feedback was provided to staff. Supervision and training records showed that supervision and staff training took place and was up to date. This ensured that people received care from staff that were suitably skilled to deliver care and feedback was continuously given on their performance.

The agency supported 30 people. We looked at six care files, five staff files, spoke with five staff, the manager, and 10 people that used the service and or their relative.

People told us they were happy with the care they received and that staff treated them with respect. People's needs were assessed and care planned so that people's needs were met. Their views and experiences were taken into account in the way the service was provided. Risk assessments had been reviewed and updated. One person said, "It's very good, better than the help I had before." Another person said, "They are reliable and good now."

People were protected from harm. The recruitment process was robust and staff training ensured staff had the skills and knowledge to meet people's needs safely. One staff member said, 'We have had additional training such as safeguarding and medicines. We have staff meetings and meet with our manager. It's much better.'

Some records did not show that medication had been given to people as prescribed by their doctor so as to ensure their health needs were met.

Improved, robust quality monitoring processes ensured people received a good, safe, service.

We found that respectful language and names were not always used in documents. Some records sampled referred to people by surname, or by function such as a 'double' or a 'pad change'. This meant that people were not respected and treated in a person centred way.

Records available were incomplete, lacked detail and did not give staff the information they needed to enable them to provide care to people in a way that met their needs safely.

All people said they were unhappy with the care because of staff unreliability and attitudes. One person said, 'We have a few regular carers who are good but most are late and don't know what they are doing. Some don't come at all.' This meant that people were at risk of harm

People did not always receive their medication as prescribed which placed them at risk of harm.

Systems were not in place to protect people from harm. Staff were not always trained and supervised to ensure good care and support was provided that met people's individual needs.

There were no systems in place to audit and monitor the quality or the safety of the service. People told us that concerns they had raised about care calls being missed or the suitability of staff, had not been listened to.

We have shared our concerns with the local authority.