Archived: Dovetail Care Limited

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.

We carried out an inspection in March 2015, and found the management of medicines did not protect people from the risk of unsafe care or treatment, staff members did not receive appropriate support and training, care plans were not updated on a regular basis, some sections were not completed or were inaccurate, People who were unable to make some decisions relating to their care and support had not received an appropriate and decision specific mental capacity assessment and the provider had failed to monitor the quality of the service to identify issues. We told the provider they needed to take action; we received an action plan. At the inspection on 8 and 9 September 2016 we found the service was breaching two regulations.

Dovetail Care is situated in the Horsforth area of Leeds and provides home care to clients of all age ranges with varying needs, including those with disabilities, visual or hearing impairments, mobility restrictions and Alzheimer’s disease.

At the time of our inspection the service had a manager and deputy manager who worked alongside the provider. The manager was in the process of registering with the Care Quality Commission. 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.

On the day of inspection the current CQC rating for Dovetail Care Limited was not on display in the office or on the provider’s website. The provider told us they would rectify this immediately and this was an oversight.

At this inspection we saw improvements had been made with the safe management of medicine, however, there were still some areas of improvement required. When necessary staff involved health professionals or the emergency services to make sure people's health care needs were met. People were supported to have enough to eat and drink.

People who used the service told us they felt safe with the care they received. We found there were appropriate systems in place to protect people from risk of harm. There were policies and procedures in place in relation to the Mental Capacity Act 2005.

There were sufficient numbers of staff to meet people’s needs and keep them safe. We received mixed views from people we spoke with regarding regular staff, visit times and if they were informed of any changes.

We found people were provided with care and support by staff who had the appropriate knowledge and training to effectively meet their needs. Staff told us they felt well supported and had received supervision in recent months. Robust recruitment processes were in place and were followed.

People were treated with dignity and respect by staff. Staff knew people well and were able to describe how individual people preferred their care and support delivered. People we spoke with were aware of how to make a complaint and felt they were listened to.

People we spoke with told us they were happy with the service they received and staff were kind and caring. The care plans we looked at were person-centred and reviewed on a regular basis to make sure they provided accurate and up to date information.

The manager and deputy manager were working with the team, monitoring and supporting the staff to ensure people received the care and support they needed. Staff spoke positively about the management team. There were systems in place to monitor and improve the quality of the service provided. Although, the provider and manager were unable to fully demonstrate how the service managed the administration of medicines safely.

On the day of inspection the current CQC rating for Dovetail Care limited was not on display in the service or on the provider’s website.

We found breaches in regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.

Dovetail Care is situated in the Horsforth area of Leeds and provides home care to clients of all age ranges with varying needs, including those with disabilities, visual or hearing impairments, mobility restrictions and Alzheimer’s disease.

The service had a registered manager. 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 were not protected against the risks of unsafe management of medicines. Risk assessments were not always completed for people who used the service. Staff training records showed staff had completed a range of training sessions, however, some specific medical condition training had not been completed, for example, Parkinson’s awareness and some existing staff training was not monitored by the management team. Staff supervision and competency checks were not completed.

The registered manager told us people did not have decision specific mental capacity assessments or best interest documentation in their care and support plans if they lacked capacity to make decisions for themselves. People’s care and support plans were not comprehensive and did not fully describe how staff should provide their care and support. We found there were no effective systems to monitor and improve the quality of the service provided. Complaints were investigated in a timely way, however, on occasion the complainant had not received a response following the investigation and it was not clear what action the service had taken to resolve the complaint.

People who used the service told us they felt safe with the staff and the care they were provided with. People and relatives we spoke with gave mixed views about the service but said staff were kind and caring, treated them with dignity and respected their choices. People received assistance with meals and healthcare when required.

There were enough staff to meet people’s needs. Robust recruitment procedures were in place and staff received an induction.

People who used the service, relatives and staff all told us the management of the service was generally good.

We found breaches in regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the end of this report.

The Manager told us, 'All care packages are client focused and they have choices about what they want in their care package.'

People's needs were assessed and care and support was planned and delivered in line with their individual care plan. The care plans were written in a person centred way and described the likes and dislikes for each person. We saw that care plans contained guidance for staff about the way each person should be supported and cared for.

Staff also showed a good understanding of person centred care. One staff member said, "Care is about how you would look after your own family, I always try and remember that."

The Provider had a policy in place for safeguarding people from abuse.

Staff told us they had received appropriate training and would report any safeguarding concerns to the Manager. They also told us they were aware of the 'whistle blowing" policy and how to contact external agencies who could assist if they felt that the management team were not taking their concern seriously.

People who used the service were complimentary about the staff. Their comments included:

"Staff are very caring in what they do."

We looked at the recruitment process for four members of staff. The files had all the relevant information to confirm these recruitment.

There have been no complaints made about the service in the past 12 months.