Archived: Home Care Direct

We received information in 2014 raising concerns about the management of the service, how complaints were dealt with and how staff were recruited. We looked at these areas in the inspection visit.

This is a summary of what we found.

Is the service safe?

We saw that the service had an up to date policy on safeguarding adults at risk and that staff knew how to report any suspicions of abuse. Some staff we spoke with were concerned that they received insufficient training to provide safe care.

The recruitment of staff was thorough and ensured all legally required information was in place before staff commenced work. This meant the provider ensured suitable people were employed,

Is the service effective?

Not all staff felt they were well supported. Some told us they had insufficient training in specific areas and that it was difficult to contact the office. This meant that issues raised were unresolved.

We saw staff training booklets contained sufficient information to provide guidance to staff on essential areas and that there was also specialist information made available according to people's individual needs.

We found people's health and medical needs were addressed and appropriate professionals were involved as necessary.

Is the service caring?

People we spoke with praised their care workers and confirmed their privacy and dignity was upheld. One person told us 'They wait outside the wet room and I call them in' and another said 'They're spot on'.

We were also told staff had a good rapport with people using the service and in most cases gave both practical and emotional support to the whole family involved. They confirmed staff were very reliable and attended promptly, providing a professional and caring service.

Feedback from external professionals we spoke with was generally positive and they felt the needs of the people they were involved with were being met.

Is the service responsive?

We found there were some dissatisfaction with the way the provider responded to issues raised by staff. Staff told us 'We have asked for training but nobody listens. We're just a number. It's difficult to get hold of anyone at the office' and an external health and social care professional we spoke with also told us that 'Communication could be better'.

We found the provider had a clear complaints procedure and that most formal complaints were dealt with. The provider had also taken specific action in relation to a repeated complaint.

We saw the information contained in people's care records was personalised and specific to their individual needs. For example, on one record we saw details of the person's daily routines and on another we saw the information was provided in pictorial format showing the person's likes and dislikes.

Is the service well led?

We had received information in July 2014 about the management of the service. We had received a written explanation from the provider about the information provided. The registered manager had taken another role in the service and there was currently no one in the registered manager position. This meant there was the potential for a lack of accountability in the management of the service.

We received some negative feedback about communication with the office from people using the service; one said 'There is definitely a lack of communication and it could be better handled and run more smoothly'. A number of staff were also dissatisfied with the response from the office. One told us 'I have given up ringing and just email now' as they said it was hard to get a verbal response by phone. This meant the provider was not always providing sufficient support for staff to enable them to meet people's needs.

People we spoke with told us they could make comments about the service. They told us they had completed a survey in 2014 and records we saw confirmed this. One person said 'I've had a questionnaire to complete and the carer also gets a form to say how good the training is. I think the lady trainer is brilliant.'

We saw that the provider had well established quality assurance procedures and that action plans were devised if any issues were found.

We found that people's needs were assessed and care was planned and delivered in line with their individual care plan. People we spoke with were positive about the care and support they received. One person said, 'I'm very happy with them ' I wish I'd known about them years ago.' A relative told us, 'They understand him very well. They know when he's ill and they take action straightaway. We all work well together'.

There were effective recruitment and selection procedures in place. Some staff were relatives who were already providing care to the person, or staff already employed by the person. Home Care Direct took over the employment of existing staff and organised recruitment of new staff. One person told us, 'Home Care Direct took over the employment of my staff and this has taken the stress away from me.'

Staff received appropriate training, supervision and appraisal. People using the service, their representatives and staff all told us there was sufficient training to ensure that people's needs were understood and met.

There were effective quality checking systems to manage risks and assure the health, welfare and safety of people using the service.

Most of the people we spoke with were positive about the service that they, or their relative, received. We found that people were usually involved in making decisions about their care and support. People were often cared for by relatives who were also employed by Home Care Direct. Most people told us they were fully involved in planning their care budget, how it was to be used, and in selecting staff. People's needs were assessed and they received care that met their needs. However, we found that the planning of care to meet people's needs did not always ensure their welfare and safety.

People told us they were sometimes frustrated by problems with getting through to the Home Care Direct office and with getting a timely response from staff working in the office.