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Archived: Direct Health (Sheffield) Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

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 pl

Inspection areas

Safe

Requires improvement

Updated 21 December 2016

The service was not consistently safe.

Improvements had been made with the safe management of medicines although some areas of management still required improvement.

Better systems were needed to ensure sufficient numbers of staff were deployed to meet people’s needs at preferred times.

Risks to the health, safety or wellbeing of people were identified and recorded in people’s records. These records formalised any actions to be taken in regard to those risks.

Processes were in place to protect people from abuse. Staff were aware of their duties and responsibilities in responding to abuse.

Effective

Requires improvement

Updated 21 December 2016

Some areas of the service were not effective.

Improvements had been made with the training, support and supervision of staff to maintain and update their skills and knowledge so that people received effective care. Progress had been made with annual appraisals, but we found a number of staff had not received this.

People were asked for their consent before care and support was provided.

People were supported to have sufficient to eat, drink, maintain a balanced diet and access healthcare appointments where this was part of their care routine.

Caring

Good

Updated 21 December 2016

The service was caring.

Staff respected people’s privacy and dignity and knew people’s preferences well.

People said staff were caring in their approach.

People’s care records had been updated. The information in them was generally brief but they were personalised to the individual.

Responsive

Requires improvement

Updated 21 December 2016

The service was not always responsive.

People’s support plans contained accurate information and the majority had been recently reviewed to ensure they were up to date.

Some people told us their care plans did not reflect all their wishes and preferences especially in regard to preferred visit times.

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.

Well-led

Requires improvement

Updated 21 December 2016

The service was not always well-led.

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.