Background to this inspection
Updated
1 September 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 took place on 22 June 2017 and was announced. The provider was given 48 hours’ notice as we needed to be sure that someone would be at the location. The inspection was undertaken by one inspector.
We reviewed the information we held about the service. We also looked at statutory notifications sent to us by the service. A statutory notification is information about important events which the provider is required to send to us by law.
We looked at information we held about the service and reviewed information sent to us from other stakeholders, for example, the clinical commissioning group and the local authority.
We spoke with the registered manger, the director, one staff member and one relative. We reviewed two people’s information, to see how their care and support was planned and delivered and looked at other records related to people's care. This included information relating to quality assurance, complaints and accidents and incidents.
Updated
1 September 2017
Destiny 24/7 provides personal care to adults in their own home. It also provides a recruitment service which supplies staff to the adult social care sector. This element of the service does not require to be registered under the Health and Social Care Act 2008. We focussed our inspection on the people in receipt of personal care only. This announced inspection took place on the 23 June 2017and two people were using the service.
During this comprehensive inspection we found multiple breaches of the Health and Social Care Act 2008 [Regulated Activities] Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.
We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because risks to people's safety had not always been assessed before care and support was delivered. Staff had not been trained with specialist training. Assessments and care plans did not always provide staff with specific information about how the person's care needs were to be met, and were not always in place before care was being delivered. Audits and governance systems were not in place. You can see what action we told the provider to take at the back of the full version of the report.
The service was run by the provider who was also the 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 and associated Regulations about how the service is run.
The provider did not have a robust approach to monitoring the quality of the service people received and did not act in an open and transparent way. The registered manager did not give complete and accurate information about the number of people they were providing personal care to, although this was not the case at the time of the inspection.
Care plans were not always in place and did not reflect the support that each person required. Assessments to consider what support the person needed were not always carried out before care was delivered to them. Information about how people’s health needs affected their daily living was not always recorded. Because of this, there was potential risk because their processes were not robust or clear or being followed.
Staff had been trained to support people to take their medicines, but the registered manager had not checked that staff were competent to do this safely. At the time of the inspection no one required assistance to help take their medicines. Because of this, there was the potential of unsafe practice to occur.
People did not require assistance to eat and drink to maintain their health, but when the registered manager carried out assessments before the person received care they explored this area. The registered manager supported people to have access to health professionals when needed.
Relatives told us they felt their family member was safe when staff visited them, and the registered manager and staff understood their responsibilities in terms of safeguarding people from abuse.
Staff understood the principles of the Mental Capacity Act 2005 and had been trained. Written consent was not always obtained before the service was provided but staff told us they asked for people’s consent before supporting them.
Relatives told us they felt able to raise any concerns with the registered manager and staff told us that the registered manager was approachable and accessible.