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Inspection Summary


Overall summary & rating

Good

Updated 25 July 2018

This was an announced comprehensive inspection which took place on 21 and 26 June 2018.

This service is a domiciliary care agency. It provides the regulated activity personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of our inspection there were 218 people using the service.

Not everyone being supported by Direct Care (Tameside) receives a regulated activity; CQC only inspects the ‘personal care’ service being received by people; which includes help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service was inspected in January 2017 when we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. These were in relation to medicines management and governance systems, including how accidents and incidents were recorded and monitored. We issued requirement actions. The service was rated requires improvement overall. Following the inspection we asked the provider to complete an improvement plan to show what they would do and by when to improve the key questions, is the service safe and well-led to at least good.

During this inspection we found the required improvements had been made.

Medicines were managed safely and people received their medicines as prescribed.

There was a good system of quality assurance in place. Weekly and monthly checks and audits were carried out by the registered manager and other managers of the service. These were used to assess, monitor and review the service.

Detailed records of accidents and incidents were kept. Managers of the service kept a log of all accidents and incidents so that they could review the action taken and identify any patterns or lessons that could be learned to prevent future occurrences.

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 service had two registered managers. One of the registered managers was newly registered with CQC, the other was one of the providers of the service and had been in post for some time. They told us that they were remaining registered to provide support and guidance to the new registered manager until they had finished their induction and would then deregister.

People who used the service and staff we spoke with were positive about both the registered managers.

There was a safe system of recruitment in place which helped protect people who used the service from unsuitable staff. Staff received the induction, training, support and supervision they required to carry out their roles effectively.

Staff we spoke with were aware of safeguarding and how to protect vulnerable people. Staff were confident any issues they raised would be dealt with properly. There were systems in place to protect people’s security and their property.

Risks to people who used the service and staff were assessed. Guidance was given to staff on how to minimise those risks. Suitable arrangements were in place to help ensure people’s health and nutritional needs were met.

People who used the service told us they were consulted about the care provided and staff always sought their consent before providing support. The requirements of the Mental Capacity Act (MCA) 2005 were being met. People were supported to have maximum choice and control of their lives.

Care visits were well organised, staff worked in geographical teams. This helped to provide consistency of support. People told us visits where rarely missed.

The provider was part of a pilot project and was developing more effective, holistic and outcome based practices for meeting peoples care needs. This was being trialled in two local g

Inspection areas

Safe

Good

Updated 25 July 2018

The service was safe.

Medicines were managed safely. There were policies and procedures in place and staff had received training in administering medicines.

Risks to people were identified and guidance given to staff on how to minimise those risks. Detailed records of accidents and incidents were kept.

The recruitment of staff was safe and there were sufficient staff to provide the support people needed.

Effective

Good

Updated 25 July 2018

The service was effective.

Staff had received the induction, training and supervision they required to ensure they were able to carry out their roles effectively.

The provider was meeting the requirements of the Mental Capacity Act 2005 (MCA). People�s rights and choices were respected.

The service was well organised and people received consistent support from staff they knew.

Caring

Good

Updated 25 July 2018

The service was caring.

People told us staff were caring and kind.

The registered managers and staff knew people well and took pride in providing good, person centred care.

Managers and staff placed great importance on maintaining and promoting people�s independence and choice.

Responsive

Good

Updated 25 July 2018

The service was responsive.

Care records were detailed and person centred. They contained information about people�s needs and wishes. They provided staff with the information they needed to support people appropriately.

The support provided was reviewed regularly, people and those who were important to them were involved in those reviews.

There was a suitable complaints procedure for people to voice their concerns.

Well-led

Good

Updated 25 July 2018

The service was well-led.

The systems in place to assess, monitor and improve the quality and safety of the service were sufficiently robust.

People were very positive about the service and the way it was managed and organised. Staff enjoyed the working for the service and felt supported in their roles.

The registered managers were committed to providing a responsive and person-centred service.