We carried out a review of the data available to us about Direct Care (Tameside) 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 Direct Care (Tameside), you can give feedback on this service.
Direct Care (Tameside) is a domiciliary care service providing care and support to people in their own homes in the Tameside area of Greater Manchester. At the time of our inspection, they were supporting approximately 220 people.
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
People told us they were very happy with how they were supported. They told us care workers were reliable and usually arrived at the time they were expected. People told us they did not feel rushed and were supported at their own pace. Care workers told us their rotas allowed them to spend the time they needed with people and were organised so care workers worked in one area rather than having to travel to different areas between visits.
The registered manager and other management staff understood their responsibilities. They had worked successfully with the local authority to try new ways of working to improve outcomes for people. The local authority felt the service was run with the best interests of people they supported. Incidents and concerns were investigated thoroughly and were analysed to identify if anything could be put in place to prevent things recurring. Some notifications had not been sent to CQC however we are satisfied measures have been put in place to ensure this happens in the future.
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 25 July 2018)
Why we inspected
We undertook this targeted inspection to check staffing and to ensure the managers and staff were clear about their roles and responsibilities. The overall rating for the service has not changed following this targeted inspection and remains good.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We found no evidence during this inspection that people were at risk of harm from these concerns.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
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 geographical areas. It also included a more person-centred approach to care planning and recording.
People who used the service and their relatives were very positive about the caring and kind attitude of the staff. Staff knew people well and spoke about people in respectful and affectionate terms. Staff enjoyed their work, took a pride in the care they provided and had a very good knowledge of people they supported.
Staff we spoke with enjoyed their work, took a pride in the care they provided, had a very good knowledge of people they supported and demonstrated a commitment to person centred care.
Care records we reviewed were very person centred and included what was important to and for the person, including their routines, interests and preferences. People were supported in their own homes and to access community activities and events.
People who used the service were very positive about the service and the way it was managed and organised. Staff we spoke with liked working for the service and told us they felt supported in their work.
We found all members of the management team had a good knowledge of the care and support needs of the people who used the services from Direct Care (Tameside). All the staff we spoke with during our inspection shared the registered managers passion and commitment to providing person centred care.
The service had notified CQC of any accidents, serious incidents, and safeguarding allegations as they are required to do. The provider had displayed the CQC rating and report from the last inspection on their website and in the office.
This inspection took place on 5 and 6 October 2016 and was announced. We gave the service notice of our inspection to enable them to organise suitable staff cover to assist with the inspection process.
The service had been registered with the Care Quality Commission (CQC) since November 2013 and this was the service’s first inspection.
Direct Care has offices in Stalybridge, Tameside and provides care and support to people living in their own homes in the surrounding Tameside and Glossop areas. At the time of our inspection Direct Care was providing a service to 166 people.
The service had a registered manager in place. 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.
We identified breaches of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were in relation to the management and administration of medication and the recording and management of accidents and incidents and good governance of the service. You can see what action we told the provider to take at the back of the full report.
People spoke highly of the service; one person told us, “I’m very pleased with the care. I’m very happy with it.”
We found management and staff were kind and caring and spoke highly of the people they provided a service to and told us how much they enjoyed their caring role.
The staff files we looked at showed us that safe and appropriate recruitment and selection practices had been used to ensure that suitable staff were employed to care for people who may be vulnerable.
Staff we spoke with were aware how to safeguard people and were able to demonstrate their knowledge around safeguarding procedures and how to inform the relevant authorities if they suspected anyone was at risk from harm.
Staff told us they had their own service round and saw the same people each time. This consistency in care staff visits was confirmed during telephone conversations with people who use the service.
Care files we looked at showed comprehensive plans and risk assessments documenting people’s specific care and support needs. These were detailed plans outlining how people needed to be cared for in an effective, safe and personalised way. The plans included detailed information around their preferences. Additionally, we saw that these care files were regularly reviewed in a comprehensive way; meaning that information in the files was current and up-to-date to ensure people received the correct care and support.