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Dana Home Care

Overall: Good read more about inspection ratings

18 Lodge Road, London, NW4 4EF (020) 3191 8899

Provided and run by:
Care Worldwide (London) Limited

Important: The provider of this service changed. See old profile

All Inspections

17 January 2019

During a routine inspection

About the service: Dana Home Care provides personal care to people across five supported living locations. At the time of the inspection, 13 people over the age of 18 with learning disabilities, were using the service.

People’s experience of using this service:

The provider had made improvements to the service since our last inspection on 21, 22 and 28 November 2017.

New procedures had been embedded which resulted in medicines being managed safely. People received their medicines as prescribed.

Required checks were completed to ensure new staff were suitable for their role.

People and relatives told us the staff were kind, friendly and dedicated. Staff were knowledgeable around people’s needs.

Processes were in place to ensure that people could raise concerns. Complaints were investigated and responded to.

The provider used their staff, leaders and management team to achieve compliance with the regulations. The provider had provided the necessary support to enable satisfactory organisational change.

Governance of the service had improved. Checks and audits were carried out to determine the quality of the care. The provider had promptly acted on some areas already identified for improvement. The provider had also submitted all required notifications to CQC.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service met the characteristics for a rating of "good" in all the key questions we inspected. Therefore, our overall rating for the service after this inspection was "good".

More information is in our full report.

Rating at last inspection: At our last inspection, the service was rated "requires improvement". Our last report was published on 23 January 2017.

Why we inspected: All services rated "requires improvement" are re-inspected within one year of our prior inspection. This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

21 November 2017

During a routine inspection

This service provides care and support to people living in five ‘supported living’ settings, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Not everyone using Dana Home Care receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’ which is help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager. This 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.

At the last inspection of this service, in January 2016, the service was rated ‘Good’. The service’s rating is now ‘Requires Improvement’, the first time it has received that rating.

The service was not consistently ensuring the proper and safe use of medicines. One person had not received the medicines as prescribed, and records relating to medicines were not always accurate.

The service worked with people whose behaviour could challenge. Staff were trained to use restraint as a last resort. However, there were sometimes inconsistencies between different records of the same instance of restraint or sanction. Reviews had not identified this potential safety risk.

Staff recruitment checks were not sufficiently comprehensive, and signs of unsuitability were not always given due attention. Some staff were employed before these checks were completed. This did not assure that these staff were safe to work with people using the service.

Although some complaints from people using the service were paid due attention, the complaints system was not effectively operated due to inconsistencies with identifying, recording and responding to other complaints.

The service relied too much on our interventions to support continuous learning and improvement. For example, three police incidents and a safeguarding matter were not notified to us, as required by legislation, until we pointed this out to the management team. Improvements to systems of reviewing sanctions and restraints were only made following our interventions.

There were a number of audit systems used at the service. However, we found that issues that were identified from these processes were not always addressed. Additionally, the provider’s governance processes did not identify a number of concerns and service shortfalls we found.

Nonetheless, the service promoted a positive culture that achieved good outcomes for many people. People and healthcare professionals generally fed back positively about the service they received.

The whole service worked in co-operation with other organisations to deliver care and support that, on the whole, improved people’s quality of life. People were treated with kindness, respect and compassion, and were given emotional support when needed. Attention was paid to supporting people’s varied communication needs, to help them be better understood and more trusting of staff.

As far as possible, the service supported people to express their views and be actively involved in making decisions about their care and support. Consent to care was sought in line with legislation and guidance.

People received personalised care that reflected their needs and preferences. Their independence was respected and promoted, though balanced with assessments of safety risks. People were supported to engage in preferred activities, study and employment, both at home and in the community.

People accessed healthcare services, received ongoing healthcare support, and were supported to maintain a balanced diet. For example, some people were losing weight as planned, and being encouraged to eat healthier meals.

The service provided enough staff who worked regularly with people. Staff were supported to gain the skills and knowledge to deliver the care and support people needed.

We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

5 January 2016

During a routine inspection

This was an announced inspection that took place on 5 January 2016. This was the first inspection of this service as operated by this provider. At the time of our visit, the service was providing personal care support for four people at three different supported living schemes. The provider also has registration for three care homes, all of which are located close by.

Dana Home Care provides care in your own home and supported living services. Its stated specialisms include dementia, eating disorders, learning disabilities, physical disabilities and sensory impairments.

There was 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. The registered manager of Dana Home Care is additionally registered as manager for one of the provider’s local care homes.

People and their relatives, and community professionals, provided positive feedback about the service. We saw evidence indicating that the service had supported people to develop their skills and reduce behaviours that challenged. People’s positive behaviour guidelines provided clear and individualised guidance to staff on how to encourage positive behaviours and respond to risks.

There were enough staff working to meet people’s needs. The service safely supported people to attend to health, medication and nutritional needs. The staff we spoke with were knowledgeable about the needs and preferences of people they supported. They had appropriate skills and provided care and support in a professional and friendly way that was focussed on the individual.

People were supported by consistent set of staff who knew their individual communication needs, which helped positive and caring relationships to develop. People’s privacy and dignity were respected and promoted by staff whose recruitment considered whether they had a caring approach.

There was a positive and enabling culture that focussed on empowering people using the service. The service enabled people to raise complaints, including through regular meetings for people at each scheme.

The service’s management team was approachable and responsive. They encouraged feedback and consistently monitored and assessed the quality of the service provided. Further work was needed with ensuring that the principles of the Mental Capacity Act 2005 were consistently applied for everyone using the service, however, the management team showed that they were trying to address this.