Archived: Direct Health (Sheffield)

Updated 21 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 inspection took place on 28 September 2016.

The registered provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

Prior to the inspection we reviewed the PIR and other information we held about the service. We looked at previous inspection reports and notifications received by the Care Quality Commission. A notification is information about important events, which the registered provider is required to tell us about by law.

We spoke and met with the local authority care services team and the local authority safeguarding team on a regular basis.

The inspection team was made up of three adult social care inspectors and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The area of expertise for both experts by experience was in supporting people to use domiciliary care agencies.

We visited and spoke with nine people in their homes and four of their relatives. We also saw care and medicine records which were kept at people’s homes. We revisited two people who we saw during the March 2016 inspection so we could monitor any improvements in care and medicine records and gain the views of the same people and their relatives.

During the inspection we contacted 41 people who used the service. We were able to speak over the telephone with 14 people who used the service and eight of their relatives. We contacted 12 Direct Health (Sheffield) care staff and were able to speak with six of them.

We visited the agency office on 28 September 2016 and we met and spoke with the Sheffield manager, a manager responsible for the Barnsley area of Direct Health(Sheffield), Direct Health(UK) Ltd area manager, operations lead and head of human resources, two care co-ordinators and an assessor of people’s care.

We spent time looking at written records, which included ten people’s care records, six staff records and other records relating to the management of the service such as training records and quality assurance audits and reports.

Updated 21 December 2016

The inspection took place on 28 September 2016, and was an announced inspection. Prior to this we visited and spoke with people in their homes. We spoke over the telephone with people who used the service. We also contacted and spoke with Direct Health (Sheffield) care staff.

The manager of Direct Health (Sheffield) was given 48 hours’ notice of the inspection, because the location provides a domiciliary care service; we needed to be sure that the manager and some care staff would be present to talk with. We also wanted the service to make initial contact with some people, who we had identified we would like to visit, to ask them if we could visit them in their own homes.

Direct Health (Sheffield) is a domiciliary care service. The agency office is based in the Attercliffe area of Sheffield. They are registered to provide personal care to people in their own homes in the Sheffield, Barnsley and Rotherham areas of South Yorkshire. At the time of our inspection the service was providing personal care for approximately 320 people. There were approximately 160 staff employed by the agency and they delivered approximately 2,600 hours of personal care each week.

The service was last inspected on 16 and 17 March 2016 and was found to be in breach of six regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were breaches in; Regulation 9; Person-centred care, Regulation 12; Safe care and treatment, Regulation 10; Dignity and respect, Regulation 16: Receiving and acting on complaints Regulation 17; Good governance and Regulation 18; Staffing.

The overall rating for the service was 'Inadequate'. At the last comprehensive inspection this provider was placed into special measures by CQC. This inspection found that enough improvement had been made to take the provider out of special measures.

It is a condition of registration with the Care Quality Commission that the service has a registered manager in place. 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.

The registered provider appointed a new manager in April 2016 who was in the process of applying for registration as manager of the service at the time of this inspection.

Since the inspection on 16 and 17 March 2016 the registered provider has worked closely with representatives of the local safeguarding authority and contracts and commissioning departments of the local authorities. An embargo on new placements was agreed with CQC and a detailed action plan was developed, implemented, monitored and reviewed. We have also met regularly with the local authority and registered provider to discuss progress and monitor improvements.

At this inspection we found the registered provider had taken significant and effective action to improve the quality and safety of services provided in all areas of service delivery.

Improvements had been made with the safe management of medicines although further improvement was still needed.

People said they felt the service had made some improvements particularly in relation to the times care staff visit. Other people still said their preferred visit times were not being met. Better systems were needed to ensure sufficient numbers of staff were deployed to meet people’s needs at preferred times.

Risk assessments for people who received a service had been updated and were in place in the care files we checked.

Staff were receiving regular supervisions, observation in practice checks and training updates. Some staff had not received an annual appraisal.

People said staff were caring and respected their privacy and dignity.

People's needs had been assessed when they started to use the service and all but one care plan we checked had been reviewed and were up to date.

Some people felt the service had made some improvements. Some people however said they had little confidence in the registered provider and felt they were not listened to and the concerns they raised weren’t acted upon.

Some people, relatives, staff and stakeholders said the new manager was “making a difference” and described them as hard working, approachable and a person who promoted strong care values and was committed to service improvement.

A number of improvements had been made in the management and leadership of staff which had resulted in the provision of safer and effective care for a number of the people who used the service. There was still some room for improvement in a number of areas including medicines management, staff support, effective communication with people and staff, and quality assurance.