Archived: Dovetail Care Limited

Updated 21 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was an announced inspection carried out on 9, 11, 15, 16 and 30 January 2018. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure they would be in.

Inspection activity started on 9 January 2018 and ended on 30 January 2018. It included telephone calls to people who used the service, relatives and staff. We visited the office location on 9 and 16 January 2018 to see the registered manager and office staff; and to review care records and policies and procedures.

The inspection was carried out by one adult social care inspector and an expert- by- experience who had experience of domiciliary care services. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before our inspection, we reviewed all the information we held about the service, including previous inspection reports and statutory notifications sent to us by the provider. Statutory notifications contain information about changes, events or incidents that the provider is legally required to send us. We contacted the local authority, other stakeholders and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

Before the inspection, the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we spoke with nine people who used the service, two relatives, five care staff, the administrator and the registered manager.

We spent time looking at documents and records related to people’s care and the management of the service. We looked at six people’s care plans and six people’s medicines records.

Updated 21 February 2018

This was an announced inspection carried out on 9, 11, 15, 16 and 30 January 2018. At the last inspection in November 2016 the service was rated as Requires Improvement. We found some improvements had been made to the management of people’s medicines. However, there were still some areas of improvement required with the management of medicines and we found there was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, safe care and treatment. At this latest inspection we found further improvements had been made but we have made a recommendation that the provider keeps medicines under review to ensure the improvements made are sustained.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. At the time of the inspection, there were 40 people receiving the regulated activity of personal care from the provider.

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 and associated Regulations about how the service is run.

We found some issues relating to the management of medicines. We also found risk management and care plans did not always contain detailed information care workers needed to support people. The registered manager took prompt action to ensure the concerns were addressed by the end of the inspection. Evidence of sustained improvement will be checked at our next inspection.

Overall, safe recruitment practice was followed. However, gaps in employment and full employment histories had not always been obtained for care workers prior to their employment. This was rectified during the inspection.

There were systems and procedures in place to protect people from the risk of harm. Care workers could describe the different types of abuse and what would constitute poor practice. Care workers understood their role and responsibilities for maintaining good standards of cleanliness and hygiene.

People said they felt safe and care workers treated them well. People spoke positively about the support they received. People told us they received a good standard of care and they were always treated with dignity, respect and kindness.

The registered manager and care workers had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. Care workers had completed an induction when they started work and had received training relevant to the needs of people who used the service. Care workers received support, supervision and appraisal to help them understand how to deliver good care.

Where needed, people who used the service received support from care workers to ensure their nutritional and health needs were met. Care workers were trained to respond to emergencies and said they felt confident to do so.

Care workers had good knowledge of the people they supported and understood how to maintain people’s privacy and dignity. It was clear they had developed positive, valued relationships with people and delivered person centred care.

There were procedures in place for responding to people’s concerns and complaints. People told us they knew how to complain. We found the service was responsive to any concerns raised.

People who used the service, relatives and care workers all spoke positively of the provider, the registered manager and management team. The provider and registered manager recognised the importance of monitoring the quality of the service provided to people. They took into account the views of people who used the service through satisfaction surveys and reviews. Unannounced spot checks of care worker’s practice were carried out to make sure people were supported in line with their plans of care.