Archived: Dementia Concern

Updated 25 May 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was conducted by one inspector and an Expert by Experience who telephoned relatives for feedback. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 15 April 2021 and ended on 26 April 202. We visited the office location on 15 April 2021.

What we did before the inspection

We reviewed information we had received about the service. We used all of this information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We took this into account in making our judgements in this report.

During the inspection

We spoke with the manager. We reviewed a range of records. This included seven people’s care records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with 12 relatives of people who used the service. We emailed seven staff for feedback and received responses from two.

Updated 25 May 2021

About the service

Dementia Concern is a community based adult service for people living in their own homes in the community. Dementia Concern comprises of dementia link workers who support people's acute needs, information and advice provided through dementia advisers, social clubs, community support and dementia cafes. We inspected the Call and Care part of the organisation that provides a respite service for people living with dementia who live at home with a family carer. The main role of the Call and Care worker was to undertake activities with people during their call, as people using the service received their personal care from either family carers or other agency care workers. However, Dementia Concern Call and Care workers provided personal care if the circumstances necessitated it. At the time of the inspection 22 people were using the Call and Care 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

During the inspection we found risk assessments were not always undertaken where risks were identified for people, and where there were risk assessments these did not always record enough detail to provide staff with the relevant guidance to provide a safe level of care. We also found medicines competency testing was not undertaken annually which placed people at risk of not receiving medicines safely.

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. However, the systems in the service did not always support this practice in terms of assessing people’s mental capacity and gaining consent.

The provider did not operate effective systems to monitor, manage and improve service delivery and to improve the care and support provided to people.

The provider had systems in place to safeguard people, and safe recruitment procedures were followed. Staff followed appropriate infection prevention and control practices. Staff were supported through training and team meetings.

There was a complaints procedure in place and people knew who to raise concerns with.

Relatives reported the manager was available and responsive.

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 27 March 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been made/ sustained and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to safe care, consent to care and good governance at this inspection.

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

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.