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West Devon & District Care & Support Limited Good

Reports


Inspection carried out on 12 July 2017

During a routine inspection

West Devon and District Care and Support Limited is a domiciliary care agency which operates in rural West Devon. It provides personal care to people in their own homes. At the time of the inspection, 30 people were receiving a personal care service.

At the last inspection, the service was rated Good overall. At this inspection, we found the service remained Good overall.

Why the service is rated good:

People confirmed that they felt safe with care staff. One person said, “I feel completely safe with them.” Staff understood how to safeguard people from abuse. Risk assessments were carried out to enable people to retain their independence and receive care with minimal risk to themselves or others. The service had safe recruitment practices which helped protect people from unsuitable staff. People were supported to receive their medicines safely and as prescribed.

People continued to receive effective care and support from staff. A comprehensive training programme ensured staff had the knowledge and skills to enable them to support people effectively. People confirmed they were always asked for consent before receiving care. Staff were aware of the Mental Capacity Act 2005 and worked within its legal framework.

People continued to praise the agency for providing a very caring service. One person said, “They’re always nice and willing and always treat me with respect. I’d give them 20 out of 20.”

People and their families confirmed that the service remained outstanding in their responsiveness to individual needs. The agency worked closely with other services to ensure that people’s needs and preferences were always met. Health and social care professionals confirmed how flexible the agency was. One professional said, “They always try and accommodate what the client wants… I find them incredibly helpful.” There had been one minor complaint since the previous inspection.

The service remained well led. A committed management team worked alongside care staff, leading by example and setting a high standard. They were well respected by staff. The quality of the service was under regular review using a range of effective monitoring systems.

Further information is in the detailed findings below.

Inspection carried out on 11 & 13 March 2015

During a routine inspection

The inspection took place on 11 and 13 March 2015 and was announced.

West Devon and District Care and Support Limited is a domiciliary care agency (known as DACCS) operating rurally in West Devon. It provides personal care to people in their own homes, who may be funded privately or through local authority commissioning. It does not provide a service to people under the age of 18. At the time of the inspection 38 people were receiving a service.

Our previous inspection visit in April 2013 found that the agency needed to ensure staff received the training they required for their role. We issued a compliance action and the agency provided evidence in August 2014 that the necessary training was now provided.

The agency has a registered manager. 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. DACCS registered manager is also the owner.

People were protected through the agency’s arrangements for staffing, recruitment, safeguarding of adults and medicine management. Risks were understood and managed in a way which protected people but promoted their independence. A social worker said, “The agency has always been good at spotting potential risks or hazards and taking prompt action to manage them.”

Staffing arrangements were flexible where at all possible and people were happy the same staff were able to visit them.

Staff received a wide variety of training which ensured they were competent in their role. Training methods varied to meet different training styles. Staff felt supported in their work, which was monitored, and advice was always available. The registered manager ensured that best practice was sought and the agency was up to date with the best ways to meet people’s needs.

People’s health and welfare were promoted through staff vigilance in recognising when input from a health care professional was required. There was excellent communication and shared working between health and social care professionals and the agency.

People were fully involved in decisions about their care and the staff understood legal requirements to make sure people’s rights were protected although capacity assessments were not always recorded.

People received care and were supported by care workers who respected them and were kind and caring. Privacy and dignity were upheld. The agency had been innovative in protecting people living with dementia by providing information in a way which promoted their dignity.

The agency was very responsive to people’s individual needs, such as keeping family together. Personalised care and support was provided to enable people to remain independent but safe. This included liaison with other care services, care agencies, taxi firms, families and instigating and completing animal health care.

People were closely involved in their care planning and their views were sought through care reviews, pop-in visits and surveys. Any reasonable way of communicating was used, including email, diaries and Skype. There was a complaints policy but there had been no complaints.

The agency had systems to monitor the standard of service provided and assess and manage risk. There was an ethos of striving for continual improvement. There was a strong emphasis on valuing staff.

During a check to make sure that the improvements required had been made

We found that the agency had updated their training and supervision arrangements. This was confirmed through documents we received from the provider and talking to care workers who provide personal care to people in their own homes. The care workers confirmed that there was a lot of training currently being provided. They said that one to one supervision with their line manager was in progress. Improved training and supervision of staff means that staff will be better supported in the role and so people who use the service will not be put at any unecessary risk.

Inspection carried out on 23 April 2013

During a routine inspection

We spoke to ten people who used the service and saw the agency's survey results. The majority of responses were positive with comments including, "All have a caring attitude and are respectful" and "I am pleased with everything."

People were involved with the planning of their care and properly consenting to the care which they received. Care was planned in detail, which provided the information for care workers to follow.

The agency cooperated with other providers. A health care professional said that she had no concerns around the support one person was receiving having informed the care workers what was required of them.

People told us that they had no concerns around care workers hygiene and care workers confirmed infection control training and sufficient equipment to protect people from cross contamination.

The agency had robust recruitment arrangements to ensure that only care workers suitable to work with vulnerable adults were employed to do so.

Where we had identified outcomes were unmet during our previous inspection the agency had responded by providing training. However, other training was out of date. This may have been a factor toward a moving and handling accident following which the provider said she would bring the care workers in "for further moving and handling training whilst using equipment."

The standard of record keeping was improved which meant that there was better information to inform care workers how to provide care safely.

Inspection carried out on 22, 26 November 2012

During a routine inspection

We looked closely at the care provided to four people, which involved looking at records of their care and speaking to them or their family where available. We then rang 10 others and were able to speak to five. We spoke to the provider and four care workers/supervisors.

Comments about the care provided, all positive, included, "On the whole (the care is good) yes"; "Very good"; "Excellent care and always treated with the utmost respect"; "Wonderful. Good company and everything"; "They do the best to their ability"; "Brilliant. Friendly and do a good job" and "There were a few problems early on but they are resolved now".

People were very happy with the reliability of the service and that they had consistent care workers who visited and so were known to them. Both they and the care workers felt that there were enough staff employed to do the work well.

Some people told us that they were consulted about their care but one felt that some care workers had acted without consent within their home and one had not been consulted when the care was reviewed and their family were unable to do this without their help. There was not sufficient evidence to show that people were adequately consulted, this was partly because records did not exist or were incomplete. This meant that people were not protected from the risks of unsafe or inappropriate care.

Three people said that care workers were not consistent in washing their hands before providing care or preparing food.

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Inspection carried out on 8 March 2012

During a routine inspection

We conducted an unannounced visit to West Devon and District Care and Support Limited (known as DACCS) office on 8 March 2012 as part of our planned inspection. During that visit we saw the results, including people's comments, from surveys carried out by the agency during 2011.

We visited three people who used the service, during which time we met four care workers who were attending them and met one person's family. We then rang eight people who used the service, two care workers and two community health care professionals with knowledge of the agency.

People spoke very highly of the agency. Comments included "They're all very helpful" and "I'm so lucky. Every lady is caring friendly and kind".

We were told, and observed, that staff were competent, friendly, caring and professional. One health care professional said "Carers don't just do, they enable". Another said "Communication is very good".

People said that communication with the office was good. They confirmed that they were involved in decisions about their care and that they received visits from the agency to check the standard of care being provided.

We received only one negative comment and that related to the receiving of information about care worker visits. The agency office was already aware of the issue and talking with the person about it. Otherwise no person or staff could think of how the agency could be improved. One person, who said they had made a complaint in the past, had been very satisfied with the response.

The provider was fully aware of how to safeguard people from abuse and staff were aware of the agency's whistle blowing policy. However, one did not understand their responsibility to escalate concerns should that be necessary. There was also confusion in the agency office as to the accuracy of the training schedule/records.