DCC Amber Valley Home Care

DCC Amber Valley Home Care is a domiciliary care service providing personal care The service is registered to provide support to older people, younger adults, people with a learning or physical disability, autistic people and people who have mental health needs. At the time of our inspection there were 39 people using the service.

People’s experience of the service and what we found:

At the time of the inspection, the location did not provide care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support

Risks to people and staff had been assessed and people's care plans were regularly reviewed and updated. Staff supported people to maintain their health and wellbeing by referring people to other professionals which supported their health and independence.

Right Care

People were supported as individuals, in line with their needs and preferences, people were involved with creating their care plans and their communication needs were considered and met. People using the service were given the opportunity to express their wishes for the care they would like to receive at the end of their life.

Right Culture

The service promoted a person-centred culture. The registered manager understood their responsibilities and had identified areas to improve the quality of the service through the audit systems in place. People's needs were assessed prior to them receiving care and support from the service.

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.

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 Requires Improvement (published 21 January 2020).

Why we inspected

We undertook a focused inspection to review the key questions of responsive and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for DCC Amber Valley Home Care on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Southeast and South Derbyshire Home Care is a domiciliary care agency, it provides personal care to people living in their own houses and flats and within an extra care facility. The service supports younger adults, older people, people living with dementia and people with physical disabilities living in their own homes, Some people received a short-term reablement service following a period of hospitalisation. At the time of this inspection 258 people were using 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

Improvements had been made in the service and systems had now been developed to monitor the quality of the service provision and review how people received their support visits. These systems need to be embedded into the service to ensure these effectively maintain improvements within the service.

Support visits were now monitored to ensure people received their visits at the time they were expected and were not missed. Staff now understood their role in protecting people from harm and poor care. Where any concerns regarding potential harm or abuse were identified, this was reported to ensure this was investigated or reviewed for people’s safety.

People now had their care needs assessed and a care plan had been developed to ensure staff knew how people wanted to be supported. Care plans described the care people needed to manage their day to day support. These need to be further developed to gain people’s views regarding support towards the end of their life.

Potential risks to people’s safety were now identified, and management plans were in place to guide staff on the best way to provide care, to reduce the risks. Safe systems had now been developed to ensure people received their prescribed medicines. The staff knew when to give these and what to do if they were concerned or medicines were missed. There were recruitment procedures in place to ensure staff were suitable to work within the service.

People felt safe when they received care and made decisions about the support they wanted. People were now 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 received care and support from staff who were well trained and knew how they liked things done. People received kind and compassionate care and were supported to maintain their dignity, independence and privacy. Rotas were sent out to people each week with visit times and the names of staff who would support them. The service was flexible and responsive to changes in people’s needs. People knew how to raise concerns and were given opportunities to share their views of the service. There was an on-call system for people and staff to ring in the event of an emergency out of office hours.

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

Rating at last inspection and update

The last rating for this service was Inadequate (Published 27 June 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection and each month 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.

This service has been in Special Measures since June 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating.

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.

People’s experience of using this service:

Quality monitoring systems were in place, although these were not effective to ensure people received safe and effective care.

People were not protected from harm because care plans and risk assessments had

not always been completed to ensure staff knew how to provide their care.

Care was not always reviewed in a timely way to reflect how people’s needs had changed and how they wanted to be supported.

Systems were not in place to ensure where calls to people had been missed, this was identified as calls were not always monitored.

Where people were at risk or harm or potential abuse, this had not been suitably reported to the safeguarding team to ensure the necessary action was taken.

Systems were not in place to ensure staff understood what medicines people needed support with.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people were no longer able to make decisions about their care, assessments had not been completed to demonstrate how decision were being made in their best interests and in the least restrictive way.

Accidents and incidents were recorded but where lessons could be learnt from incidents, this was not shared with the staff team to reduce the risk of re-occurrence.

People did not always have information in a format that was meaningful to them. Where people needed support to communicate, this was not always recorded to ensure staff could support them.

Where people knew staff, they felt comfortable receiving personal care. However, sometimes they received care from staff they did not know.

People were supported to access health care services where needed and staff monitored people’s health needs.

People knew how to complain and felt confident that their concerns would be listened to or acted upon.

There were sufficient numbers of staff on duty to meet people’s care needs who were suitably recruited to work with people.

Staff understood infection control procedures and people were confident the staff followed good practices.

Staff felt they received training to update their skills and knowledge to deliver effective care.

People had a choice of what to eat and drink and when.

People continued to receive healthcare from health professionals to ensure they remained well. Appointments and outcomes were recorded, and information shared.

People could share information about how they would like to be supported towards the end of their life.

Where people knew staff who provided their care, they felt received respectful, dignified care and the staff were kind and caring.

People and staff could comment on service delivery to influence how the service was developed.

Rating at last inspection: Good (published November 2016)

Why we inspected: This inspection was brought forward as we had concerns about how the service was managed and the systems in place to ensure people received safe and effective care.

Enforcement: Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up: The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

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

This was the first inspection visit since the service registered with us in October 2014.

There was a registered manager in post. 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 staff knew how to raise any concerns to protect people from harm. We saw that risk assessments were in place to provide guidance to the equipment which was provided. When required staff had raised concerns and other equipment had been provided to support people. People told us they received support from a regular group of carers. The service ensured there was a thorough recruitment check undertaken before staff commenced their employment. When medicine support was required we saw that it was provided to meet individual’s level of support.

Staff had received training to support people’s needs and new staff received an induction to enable them to be confident in their role. This involved a training package, support from experienced staff and continued support. Staff knew about people’s individual capacity to make decisions and understood their responsibilities to support people and when relevant best interest decisions had been made. Where required people received a choice of meals and records were maintained to support people’s nutrition. People were supported to maintain their health and wellbeing with ongoing healthcare support.

People had established positive caring relationships with the staff. People were encouraged to be independent and have their needs met in a way they choose. Respect for the person was maintained and people’s dignity was upheld.

Assessments and person centred care plans had been completed to identify the care needs of the person. The service supported people to pursue their hobbies and interests. A complaints procedure was available and any concerns raised had been addressed.

The service had an open approach and clear values which staff felt supported them in their role. People were given the opportunity to provide feedback on their care and the service. A range of audits were used to monitor the quality of the service and were used to develop improvements to the service.