Archived: Divinus Support Limited

Updated 5 April 2019

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.

The inspection was carried out by two inspectors and an expert 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 expert by experience telephoned four people who used service to gain their views about the service.

This inspection took place on 12 and 14 February 2019 when we visited the service office. Two inspectors undertook the inspection on day one and one inspector on day two. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to ensure that the registered manager and staff would be available. On the first day of the inspection, one inspector visited three people in their own home and on day two an inspector interviewed members of staff.

Before the inspection we reviewed the information we held about the service; this included incidents they had notified us about. We also contacted the local authority safeguarding and contract monitoring teams to obtain their views. A Provider Information Return (PIR) had been submitted to the Care Quality Commission. The PIR 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.

We spoke with the registered manager, director, quality manager, two associate directors, one team leader, two members of care staff and two professionals from the local authority and clinical commissioning group. We reviewed six peoples care records.

We saw records about how the service was managed. This included three staff recruitment files and monitoring records, staff schedules, audits and quality assurance records as well as a wide range of the provider's policies, procedures and records that related to the management of the service.

Updated 5 April 2019

Divinus Support Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community.

This was an announced, inspection which commenced on 12 February 2018. There were 40 people using the service. We gave 48 hours’ notice of this inspection to make sure that people who used the service and staff would be available to speak to us.

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.

This inspection was bought forward from the planned date due to concerns raised by the local authority regarding the care provided to people.

At the last inspection of 29 July 2016, the service was rated Good. At this inspection we found the service has deteriorated to Requires improvement.

At this inspection, we found that there was a lack of managerial oversight of the service. Effective quality assurance checks were not in place to enable the registered manager and senior staff to assess and monitor the quality of the service. The service arrangements were not robust as they had not recognised the issues we identified during our inspection. Improvements were required to ensure that all staff employed by the service received training in the Mental Capacity Act 2005.

Despite this training not being in place we found at the time of the inspection that people were supported to have maximum choice and control of their life and staff supported them in the least restrictive way possible.

Recruitment checks had been completed on all staff before they commenced working at the service. However, processes had not been recorded with regard to employing and supporting staff of the same family. Suitable arrangements were not in place to ensure that newly employed staff received suitable training opportunities, robust induction, formal supervision and an annual appraisal of their overall performance. The provision of planned staff supervision and reviewing peoples care plans had declined over the past three months. This was due to care staff leaving the service and despite attempts, the recruitment of sufficient new staff members had not been successful. The service continued to try to recruit additional staff. As a result, the senior managers of the service were frequently providing care to people at the expense of the managerial oversight of the service.

Suitable control measures were not always in place to mitigate risks to the people using the service. Risk assessments had not been developed for all areas of identified risk to people and the service had not successfully communicated with other professionals so that there were clear care plans in place.

Despite the above, people told us that they felt safe. The senior staff were providing regular care visits and people told us that there had not been any missed calls.

The medicine records were unclear as to whether people had taken their prescribed medicines. At the time of our inspection medicines audits were not being carried out but were planned for the future.

Although staff delivering care were supporting people and people told us they were well cared for, the senior staff of the service were not always acting in a way that demonstrated that they cared about the wellbeing of the people they supported. This was because they did not ensure that the service being delivered maintained people’s safety and wellbeing.

People spoke positively about the way staff treated them and reported that they received appropriate care. Staff demonstrated a good knowledge and understanding of some of the people they cared for and supported, such as people with a diagnosis of diabetes, but this information had not always been recorded and reviewed in the person’s care plan. Staff lacked knowledge in other areas of care such as how to support a person with pressure ulcers.

People told us that their personal care and support was provided in a way which maintained their privacy and dignity. However, we found that people’s care plans did not always contain relevant and current information to guide staff on the most appropriate care people required to meet their needs.

The service had a complaints process in place and people informed us that the on-call system was effective.

You can see what actions we told the provider to take at the back of the full version of the report.