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Archived: Derwent Carers Requires improvement

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 7 May 2016

This inspection took place on the 22 and 23 February 2016 and was announced.

Derwent Carers provides a domiciliary care service offering support and personal care to 40 adults who live in their own homes.

There was a registered manager in post at this service. 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.

Recruitment processes were not safe at this service and staff had started work before checks were completed to ensure they were suitable to work with people in their own homes. The provider had not followed robust processes to gather, verify and document appropriate information about people they employed. You can see what action we told the provider to take at the back of the full version of the report.

Record keeping was not consistently robust and did not give staff clear instructions when risk issues for people with specific conditions had been identified.

We have made a recommendation about individual risk assessments.

Although inductions were completed by staff they were not recorded or reviewed appropriately. We were told by staff that they had completed an induction and saw one person working towards the care certificate which has now replaced the previously used induction. We discussed this with the provider who agreed to ensure the process was documented clearly in future.

Staff were trained in their roles and we saw that additional training was being sourced to meet the training needs of the staff. This meant that staff had the appropriate knowledge to support people.

We found that staff were offered support at monthly staff meetings, but not through supervision, on a one to one basis. Supervision and appraisal were not used to develop and motivate staff and review their practice or behaviours. Staff needs were not identified through supervision to ensure they could have regular private discussion with their manager to raise concerns or review their personal development.

We have made a recommendation about staff supervision.

People who use the service were encouraged by staff to live as independently as possible and people told us they felt they were treated with dignity, respect and compassion. People told us the staff approach was caring and made positive comments about the care they received

People told us they received person centred and individualised care that met their needs. However, the care plans we saw were brief and did not contain service reviews or guidance for staff around peoples specific conditions.

We have made a recommendation about the management of care plans and service assessments.

People who used the service and their relatives told us they were encouraged to raise concerns and they all knew about the complaints process. They felt confident about contacting the registered manager.

The service had not encouraged feedback from the people who used the service. None of the people we spoke with had received a survey to allow the service to adequately monitor and assess whether people had received a quality service.

The registered manager had not understood which areas should be notified to CQC and had not made any notifications since April 2014. A director had left in 2015 and the registered manager had not made a notification. However as soon as they were made aware of their omission they sent the notification. Notifications give CQC specific information about incidents which may affect the people who use the service.

Spot checks were carried out by the deputy manager to verify the performance level of staff working in people’s homes and these were recorded. The registered manager told us that medicine audits had been carried out, but they were not recorded, so this could not be confir

Inspection areas

Safe

Requires improvement

Updated 7 May 2016

The service was not consistently safe.

Staff were not recruited safely to ensure that they were suitable to work with people in their own homes. The provider did not follow robust processes to ensure that they gathered all the relevant information about people they employed before they started working at the service.

Risk assessments were not completed fully to keep people safe. Where risks were identified, actions and instruction for staff as to how to care for people safely were not documented and this could impact on the safety of people using the service.

Staff supported people safely to take their medicine when it was part of the support they needed.

Effective

Requires improvement

Updated 7 May 2016

The service was not consistently effective.

Staff were following the principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

The staff induction process was not documented appropriately and staff did not have access to regular one to one supervision. The staff we spoke with were all confident they could raise issues with their manager when they wanted to or at the monthly staff meeting.

Staff were trained according to their roles, which meant that staff knew how to support people to live their lives in the way that they chose.

Caring

Good

Updated 7 May 2016

The service was caring.

All the people we spoke with were positive in their comments about staff and told us that they were kind and caring.

People were introduced to their care worker before they began supporting them.

People were provided with care by staff who supported them to live as independently as possible, This meant that people, their families and carers experienced care that was empowering and provided by staff who treated people with dignity, respect and compassion.

Responsive

Requires improvement

Updated 7 May 2016

The service was not consistently responsive.

We found that the service care plans contained some information for staff relating to the needs of people. However, the care plans did not contain service reviews or guidance for staff around specific conditions people had and any associated risk.

People made positive comments about their care being person centred and individual to them and their needs.

People knew about the complaints process and how to raise any concerns they may have with the manager.

Well-led

Requires improvement

Updated 7 May 2016

The service was not consistently well led.

Quality assurance processes were not in place to adequately monitor and audit the service. Audits were not completed in a number of areas The manager told us that medicine charts were checked monthly but this was not recorded. The care coordinator was completing spot checks which audited individual staff performance on calls and this was recorded in staff files.

We found that records were inadequate across a number of areas and did not consistently contain detail or outcomes.

None of the people we spoke with were encouraged to provide feedback on the quality of the service they received.

The registered manager had not understood which areas should be notified to CQC and had not made any notifications since April 2014. A director had left and the registered manager had not made a notification.

The service held regular staff meetings and staff told us they felt the mangers were approachable and they had confidence in them.