We carried out a review of the data available to us about Dominic Care Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Dominic Care Ltd, you can give feedback on this service.
Dominic Care Ltd. is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, younger disabled adults, people living with dementia and people with a learning disability. At the time of the inspection the service was providing personal care to 70 people.
The service had a registered manager as required. A registered manager is a person who has registered with the CQC 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 was present and assisted us during the inspection.
At the last inspection the service was rated Good. At this inspection we found the service remained Good.
People received safe care from the service. Risk assessments were completed and enabled people to receive care with a minimum of risk to themselves or the care staff. Robust recruitment procedures were followed to ensure as far as possible only suitable staff were employed. Staff were trained to safeguard and protect people. They reported concerns promptly when necessary. People received their medicines safely when they required them.
People continued to receive effective care from staff who were trained and had the necessary skills to fulfil their role. Staff felt supported by the one to one meetings, appraisals and staff meetings which provided time to seek advice, discuss and review their work. They had opportunities to develop their skills and knowledge as well as gain relevant qualifications.
When required, people were supported with nutrition and hydration. People’s healthcare needs were monitored and advice was sought from healthcare professionals when necessary. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible, the policies and systems in the service supported this practice.
The service remained caring and people reported staff were kind and patient. People’s privacy and dignity were protected, they told us staff treated them with respect. People and when appropriate relatives were involved in making decisions about their care.
The service remained responsive to people’s individual needs. Staff knew people well and individual care plans were person-centred. They focused on the diverse needs and preferences of each person and their desired outcomes. Complaints were responded to appropriately and people felt they were listened to when concerns were raised. The service was working to the accessible information standard.
At the previous inspection the service was rated as Requires Improvement in well-led. Improvements had been made resulting in it being rated Good at this inspection. Records were complete, accurate and reviewed regularly. They were updated promptly to reflect current information. The registered manager and the management team were experienced and skilled. They promoted an open, person centred culture with a strong emphasis on providing excellent care and led by example. They listened to feedback and worked toward making improvements in the service. People’s views were sought and governance systems helped monitor the quality of the service.
Further information is in the detailed findings below.
The inspection took place on 19, 20 and 22 October 2015 and was announced.
Dominic Care Ltd provides a domiciliary care service to people living in their own homes, including live in care for people where required. At the time of our inspection, Dominic Care Ltd supported 64 people with personal care, and another four people were supported with care that is not regulated by the Care Quality Commission (CQC). Regulated activities means care that a provider must be registered by law to deliver and includes providing personal care.
The service had 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. This report refers to the management team, meaning the provider, registered manager, Operations Manager and supervisors, and uses the term ‘staff’ when referring to all staff employed by the service, or the management team and care workers.
The provider did not ensure that records were always kept up to date, or that care reviews were always documented. As a result there was a potential risk that people may not receive care that met their changing needs, or were supported by staff who had not completed the required training to support them safely. However, effective communication between people, care workers and the management team, and informal monitoring systems, ensured that these risks were minimised. Care workers were informed of people’s current care needs, and completed and updated training to ensure they were able to support people safely. People were not placed at risk of harm because of poorly maintained records. We have made a recommendation that the provider seeks advice and guidance from a reputable source about the completion of records in relation to the management of the service.
People told us they felt safe with care workers. They were protected from the risk of abuse because staff understood the signs of abuse and knew how to report concerns to ensure people were safe. Safeguarding concerns had been reported to the appropriate agencies and actions taken to protect people from the risk of harm.
Sufficient care workers were available to meet people’s assessed needs, and workloads were managed to ensure care workers were able to complete planned rosters on time. Additional cover was provided by the management when required, as they were trained to provide personal care. This meant there was sufficient staffing available to cover unexpected short notice care worker absences. People were supported by care workers of suitable character to meet their needs safely.
People were protected from the risk of harm because potential risks had been identified and addressed. Care workers understood the actions required to promote the safety of people and themselves, for example in the correct use of hoists to transfer people from their beds to chairs. Guidance in people’s care plans ensured care workers understood the importance of monitoring health conditions to protect people from known and emerging risks to their wellbeing.
People received their prescribed medicines safely because care workers were trained and assessed to ensure they administered medicines safely. Actions agreed with people ensured they were prompted to take their medicines at the right time. Audits ensured that any errors in medicine administration were identified and rectified to protect people from harm.
People were supported by care workers trained and skilled to meet their identified needs. Staff were encouraged to develop skills to help them meet their roles and responsibilities effectively. Care workers were supported through supervision and appraisal to discuss issues and concerns. Action plans ensured that when areas of improvement were identified in care worker practice these were addressed to ensure people were supported effectively.
People were supported to make informed decisions about their care. Care workers understood and implemented the principles of the Mental Capacity Act 2005. Care workers supported people to eat nutritious meals, and understood the importance of protecting people from the risks of malnutrition and dehydration. Care workers understood when it was appropriate to liaise with health professionals to support people’s changing needs. Documents demonstrated that requests for reviews or equipment to meet people’s needs were raised proactively.
People told us they were treated with kindness and respect by care workers who knew and understood them. Care workers were aware of the need to encourage people to maintain their independence, but recognised when people required additional support, for example when tired or unwell.
Care workers ensured they spent time chatting with people during their visits to put them at ease and promote their wellbeing. People explained that care workers listened to what they said and provided care and support as they wanted. People told us care workers promoted their dignity when supporting with personal care and cared for them respectfully.
People were involved in discussing and agreeing the care they received. Care plans ensured care workers understood people’s needs and wishes. Care workers were able to recognise when people’s health or wellbeing altered, and understood appropriate actions to support people to manage known health conditions. Communication between all staff ensured people’s changing conditions were monitored to ensure they received the level of care they required to maintain their health.
People’s comments and feedback during care worker visits or supervisor reviews informed the care they experienced. Changes were implemented promptly when requested. Complaints were managed in accordance with the provider’s complaints procedure.
People were supported in accordance with the service mission statement, as care workers demonstrated the service values of respect, enablement and promotion of dignity. They understood the importance of providing care focussed on the needs of each individual.
The registered manager was respected by people and staff. Care workers described the management team as approachable and helpful. They ensured staff were supported to deal with the emotional impact of their roles.
Reviews and consideration of repeated trends identified areas of improvement required. Appropriate actions were implemented and monitored to ensure learning from these led to improvements in the quality of care provided.