23, 24, 26 June and 6 July 2015
During a routine inspection
This announced inspection took place on 23, 24, 26 June and 6 July 2015. We last inspected the service in November 2013. At that inspection we found the service was meeting all the regulations that we inspected.
North Tyneside Council Domiciliary Care Agency is a free short term enablement service split into four area locations across North Tyneside. The service provides personal care and support to people in their own homes, often following a discharge from hospital or referral from primary care services and usually lasting six weeks on average. At the time of the inspection support was provided to 170 adults living in their own homes. We were aware that these figures will fluctuate due to the nature of the service. We were shown documents that reported 1665 referrals being received during 2014 to date.
The service had 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 2008 and associated Regulations about how the service is run.
Medicines administration records and medicines risk assessments needed to be improved. We have made a recommendation.
People told us they felt safe. There were safeguarding policies and procedures in place. Staff knew what actions they would take if abuse was suspected. The provider had dealt with previous safeguarding concerns appropriately.
Accidents and incidents were recorded and dealt with effectively by the provider. Where issues (including complaints) had occurred, actions had been taken and lessons learnt.
The provider had plans in place to deal with emergency situations and provided an out of hours on-call system, manned by senior staff. Plans were also in place to continue care delivery in the event of adverse weather conditions.
There was enough suitably recruited and vetted staff to provide quality care to people in their own homes. The provider had ensured the staff were trained to provide the care people needed. This included basic training, as well as more specialised training using healthcare professionals when required.
The registered manager understood the requirements of the Mental Capacity Act 2005 and told us no one was subject to a court of protection order. People were encouraged to make their own decisions and where they could not, best interest decisions were made.
Some people received support with eating and drinking as part of their care package. People were provided with meals they had chosen and preferred and staff ensured drinks were left between visits for people if they required them.
Staff provided equipment for people to use in their own homes, like perching stools or shower seats.
People told us the care provided by the staff was second to none. They described it as ‘outstanding and superb’. Staff provided people with information that enabled them to understand the service they were receiving and how to complain if they needed to. There had been two complaints and they had been dealt with effectively. People told us their independence was restored by staff at the service who had supported them.
People were assessed and care plans were drawn up. When people’s changing needs were identified, they were discussed and support was tailored to suit the individual.
People and staff told us the service was well managed. A range of checks were made to ensure people’s care was monitored and the quality of the service was maintained and improved upon. People were asked for their views of the service through the use of questionnaires. Comments about the service were significantly positive.
The provider had not sent us notifications which are a legal requirement of their registration regarding, for example safeguarding incidents and deaths. After requesting further information we have judged these latest findings to demonstrate on going breaches of regulations. We have taken enforcement action against the provider and the registered manager and will report further when this action is complete.