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Dolphin Care (IOW) Limited

Overall: Good read more about inspection ratings

Willowbrook House, Appuldurcombe Road, Wroxall, Ventnor, Isle of Wight, PO38 3EN (01983) 853478

Provided and run by:
Dolphin Care (IOW) Limited

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Dolphin Care (IOW) Limited 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 Dolphin Care (IOW) Limited, you can give feedback on this service.

25 April 2022

During an inspection looking at part of the service

About the service

Dolphin Care (IOW) Limited is a domiciliary care agency providing personal care and support to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. There were 14 people being provided with personal care at the time of our inspection.

People’s experience of using this service and what we found

People told us they received safe care. Staff knew each person well and understood their needs. People were supported by staff in a safe way and risks were assessed, managed and monitored. People received their medicines as prescribed and infection control risks were managed effectively.

There were sufficient numbers of consistent staff available to meet people's needs. People spoke positively about the quality of the care they received.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by caring, well trained staff that had been subject to a recruitment and induction process.

Staff supported people to access healthcare professionals when they needed them.

The registered manager kept in regular contact with people by visiting them in their homes, checking if they were happy with the service they received and if any changes were needed. People and staff felt confident to raise any concerns or suggestions to the registered manager.

The registered manager was open and transparent. They understood their regulatory responsibilities. A quality assurance system was in place to continually assess, monitor and improve the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 3 September 2019).

Why we inspected

This inspection was prompted by the length of time since the last inspection and the previous rating of the service. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Dolphin Care (IOW) Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

6 August 2019

During a routine inspection

About the service

Dolphin Care (IOW) Limited is a domiciliary care agency providing personal care and support to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. There were 15 people being provided with personal care at the time of our inspection.

People’s experience of using this service and what we found

People were supported to have choice and control of their lives and staff supported people in the least restrictive way possible and in their best interests; however, the systems used to support this practice needed further time to become embedded in practice to ensure legal requirements were met consistently.

People’s risk assessments were not always robust or fully recorded; however, staff understood the risks and knew how to keep people safe.

Medicines were managed safely by trained, competent staff; however, medicines that people were allergic to were not always recorded on their medication records.

A new quality assurance system was in place to continually assess, monitor and improve the service; however, this needed further time to become fully effective.

People told us they felt safe being supported by Dolphin Care staff and there were new systems in place to protect people from the risk of abuse.

New recruitment procedures had been introduced to help ensure only suitable staff were employed.

Enough staff were available to complete all care calls and staff followed appropriate infection control techniques during visits.

Staff completed a wide range of training. They were competent, followed best practice guidance and received appropriate support from managers.

People’s needs were met in a personalised way by staff who were kind, caring and responsive.

People knew how to raise concerns. They had confidence in the managers and told us they would recommend the service to others.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was inadequate (published 18 February 2019) and there were multiple breaches of regulation.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since February 2019. During this inspection the provider demonstrated that improvements had been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

However, the service has been rated inadequate or requires improvement for the last three consecutive inspections. We describe what we will do about the repeat requires improvement in the follow up section below.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

4 January 2019

During a routine inspection

What life is like for people using this service:

People were happy being supported by staff from Dolphin Care. They told us their needs were met in a personalised way by staff who were kind and caring. However, we identified significant concerns with the safety and quality of the service.

Managers had not acted promptly when allegations of abuse had been made and this had led to people suffering harm. Recruitment procedures had not been followed to help ensure only suitable staff were employed. Medicines were not always managed safely. Staff had not always completed training that was essential to their role. Governance arrangements and quality assurance systems were not robust. Managers lacked knowledge and understanding of best practice guidance and CQC were not always notified of significant events.

However, people’s rights were upheld, they were empowered to make their own choices and decisions and were involved in the development of their personalised care plans.

The service met the characteristics of Good in two areas, Requires improvement in one area and Inadequate in two areas. More information is in the full report.

Rating at last inspection:

The service was rated as requires improvement at the last full comprehensive inspection, the report for which was published on 27 January 2018.

About the service:

Dolphin Care is a domiciliary care agency providing personal care to 14 people in their own homes. It provides a service to older adults. Not everyone using the service receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

Why we inspected:

This was a planned inspection based on the previous inspection rating.

Action we told the provider to take:

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Special measures:

The overall rating for this service is Inadequate and the service is therefore in special measures. This means we will keep the service under review and, if we have not taken immediate action to propose to cancel the provider’s registration, we will inspect again within six months to check for significant improvements.

20 December 2017

During a routine inspection

Dolphin Care is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to 20 older adults for a total of 138 hours per week. Each person received a variety of care hours, depending on their level of need. The CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where this is provided, we also take into account any wider social care provided.

The inspection was conducted between 20 December 2017 and 5 January 2018 and was announced. We gave the provider 48 hours’ notice of our inspection as we needed to be sure key staff members would be available.

There was a registered manager in place. 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 is also a director of the provider’s company.

At our last comprehensive inspection, in March 2017, we identified breaches of Regulations 9, 12, 13, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider had failed to ensure: that people's individual needs and preferences were assessed; that individual risks to people were managed effectively; that people’s medicines were managed safely; that people were protected from the risk of abuse; that sufficient staff were deployed; that robust recruitment processes were in place; that records relating to people’s care and the effective running of the service were complete and accurate; and that effective systems were in place to assess, monitor and improve the service.

We issued warning notices to the provider in respect of Regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, requiring them to become compliant with the regulations by 5 May 2017 and 26 May 2017 respectively. We issued requirement notices to the provider in respect of Regulations 9, 13, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following this, the provider sent us an action plan detailing the action they would take to become compliant with the regulations. At this inspection, we found action had been taken and there were no longer any breaches of regulation.

Following our inspection in March 2017, the service was placed in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

Although we did not identify any breaches of regulation at this inspection, we found further improvement was still required.

The provider had developed their quality assurance processes. However, these needed time to become fully embedded in practice. The provider used a range of methods to seek feedback from people. However, issues raised were not always addressed effectively.

Where people needed assistance to take their medicines, these were managed and administered safely. However, more robust systems were being implemented to ensure staff always received appropriate training before administering medicines to people.

Staff took appropriate action to protect people from the risk of infection. Some staff had not received infection control training, although this was being scheduled.

The provider was aware of some risks posed to staff, but had not completed individual risk assessments for staff, as required by their lone working policy. Therefore, they may not have been aware of factors that might have affected the safety of individual staff members.

Appropriate recruitment procedures were in place to help ensure that only suitable staff were employed. Staffing levels were based on people’s needs and there were enough staff available to attend all care visits.

Risk assessments had been completed for all identified risks posed to people using the service, together with action staff needed to take to reduce the risks. Staff understood their safeguarding responsibilities and knew how to identify, prevent and report allegations of abuse.

Staff encouraged people to maintain a healthy, balanced diet based on their individual needs and preferences, although most meals were planned and prepared by people or their relatives.

With the exception of infection control training, staff had completed suitable training to equip them for their role. They demonstrated an understanding of the training they had received and were appropriately supported by managers.

Staff followed legislation designed to protect people’s rights. They sought consent before providing care and acted in people’s best interests. They also supported people to access healthcare services when needed.

People told us they looked forward to their visits from Dolphin Care and said their needs were met in a caring and compassionate way. They had a team of regular staff with whom they had built positive relationships.

Staff protected people’s privacy and respected their dignity. They promoted independence and involved people in decisions about their care.

Assessments of people’s care needs had been completed and detailed care plans had been developed. These supported staff to provide personal care in a consistent and individualised way.

Staff were flexible and responded promptly when people’s needs changed. They were able to accommodate the varying level of support people needed at each visit. Staff supported people at the end of their lives to help ensure they experienced a comfortable and pain free death.

There was a complaints procedure in place. People knew how to raise a complaint. All complaints were recorded and dealt with promptly.

Records relating to the management of the service were organised. There was an open and transparent culture. The registered manager was aware of the need to promote equality and inclusion within the workforce.

10 August 2017

During an inspection looking at part of the service

Dolphin Care (IOW) Limited is registered to provide personal care and the treatment of disease, disorder and injury to people living in their own homes. At the time of our inspection, they were supporting 24 people with personal care.

We had previously carried out an announced comprehensive inspection of this service on 10, 20 and 21 March 2017. Following this inspection, the service was rated inadequate and placed into special measures. Services that are in special measures are kept under review and comprehensively inspected again within six months of the published inspection report. We expect services to make significant improvements within this timeframe. For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it at its next planned comprehensive inspection and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

During the March 2017 inspection we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These included regulations in respect of safe care and treatment; and good governance. We issued two warning notices and told the provider that we required them to take action to ensure they met those regulations by 5 May 2017 and 26 May 2017 respectively. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk

This inspection was not a comprehensive inspection to review special measures. We undertook this focused inspection to check that the provider had taken action in relation to the warning notices issued at the last inspection and to confirm that they now met their legal requirements in respect of these breaches. This report only covers our findings in relation to those two regulations. Therefore, we are unable to review special measures or amend the rating given at the previous inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk.

This inspection was announced and was carried out by one inspector on 10, 21 and 25 August 2017. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

The registered manager had assessed the risks to people and had taken action to minimise the likelihood of harm.

People received their medicines safely and in a way that met their needs. People had access to health professionals and other specialists if they needed them.

The provider had taken action to ensure staff were supported and safe when supporting people in the community.

People’s records and those related to the running of the service were accurate and up to date.

The provider had recently established a system to monitor the quality and safety of the service provided.

10 March 2017

During a routine inspection

Dolphin Care (IOW) Limited is registered to provide personal care and the treatment of disease, disorder and injury to people living in their own homes. At the time of our inspection they were supporting 33 people.

The inspection was announced and was carried out between the 10 March 2017 and the 21 March 2017 by two inspectors. The provider was given two days’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in.

There was a registered manager in place at the service, who was also one of the providers. 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.

People and their relatives told us they felt safe while being supported by care staff. However we found that the risks relating to people’s health and wellbeing, such as the risk of falls or pressure injury sores had not been documented to help staff understand those risks and the action they should take to help reduce them. Risks relating to people’s home environment were also not always identified and documented.

People’s medicines were not managed safely. The records relating to peoples medicines were not always accurate and up to date and staff did not always follow best practice guidance in respect of administering topical creams.

There were insufficient staff to meet people’s needs. This led to staff not staying with people for the length of time they had been assessed as needing. For calls where a person had been assessed as requiring two members of staff, there were occasions when only one staff member attended to support the person. The registered manager/provider did not have a robust recruitment process in place to ensure staff were suitable to support the people using the service.

The registered manager/provider failed to identify safeguarding concerns relating to people using the service and to notify the appropriate authority. Health professionals were not always called when concerns were raised in respect of people’s health and wellbeing.

The care provided to people using the service did not always reflect their preferences and individual care needs. Care records did not contain information about people’s likes, dislikes or how staff should support them in an individual way or how they preferred. Risks relating to people’s food and drink needs were not always managed effectively

People’s records of care and the records regarding the management of the service were not always accurate or up to date.

The registered manager/provider did not have an effective system in place to monitor the quality and safety of the service provided.

The registered manager/provider did not fully understand their responsibilities under their registration with CQC as a registered manager.

The registered manager/provider did not always take action to ensure that people felt supported and valued.

Staff developed caring and positive relationships with people and treated them with dignity and respect. Staff understood the importance of respecting people’s choices and their privacy.

Staff received an appropriate induction and on-going training. However, training was not always available to enable staff to meet the specific needs of people using the service.

Staff sought verbal consent from people before providing care and were aware of legislation designed to protect people’s rights.

People and when appropriate their families were involved in planning their care.

The provider sought feedback from people or their families and had arrangements in place to deal with complaints.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

During our inspection we identified a number of 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 end of the full version of the report.

1 and 6 August 2014

During a routine inspection

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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was announced.  We told the provider three days before our visit that we would be coming because the service is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.  Dolphin Care provides care, including personal care, to 20 older people living in their own homes. It has been providing care for over 15 years. There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Staff received appropriate training which was up to date in most subjects. However, training in food hygiene was not up to date. We were told one-to-one sessions of supervision were held with staff so they could talk about their work and any additional support or training they needed, but not all these sessions were recorded.

People told us their needs were met “very well”. They spoke highly of the service and said they were “very satisfied” with the care provided. One person described the service as “top notch”. Care plans provided staff with detailed information about how to meet people’s needs and people were involved in regular reviews of their care. Care plans also included risk assessments which specified action required to manage risks, such as the risk of people falling or developing infections.

When we visited people in their homes, we saw staff interacted positively with them. People and their relatives were complimentary about the kindness and friendliness of staff. Three described a lot of “banter” and “joking” which they enjoyed. One person said the staff were “very, very nice people; very polite and respectful”.

People said they felt safe with staff and appropriate policies and procedures were in place to safeguard vulnerable adults from abuse. The service followed safe recruitment practices and there were sufficient staff on duty each day to perform all the scheduled care visits to deliver care and support.

Annual surveys were conducted to gain people’s views. The latest survey showed people were satisfied with the service. One respondent said, “They do everything required and if there are any changes they listen and act accordingly.”

The service was flexible and people were able to change the times of care visits if they needed to. People told us staff were “reasonably punctual” and care visits were not “rushed”. Staff told us they were given sufficient travelling times between care visits, so did not feel pressured to leave early.

The manager told us they monitored the quality of the service by checking care plans, records of daily care and other records. Where concerns were identified, action was taken. The deputy manager conducted announced and unannounced spot checks to monitor whether staff were punctual and delivering safe and appropriate care.

Staff told us they enjoyed working for the service, took pride in their work and felt trusted. They spoke positively of the manager and deputy manager. There were plans in place to ensure the long-term continuity of the service.

17, 25 October 2013

During a routine inspection

We spoke with the deputy manager, the manager and the secretary. We also visited three of the 22 people using the service and spoke with four relatives. In addition we spoke with three members of the care staff.

We found people were satisfied with the care they received. People were complimentary about care staff. One person told us 'my girls are exceptional'. Another person said 'on the whole they are all very kind to me'. We found people were cared for according to their care plan.

At our last inspection we found staff were unable to demonstrate a sound understanding of safeguarding principles or the mechanisms for reporting abuse. At this inspection we found staff were aware of the various types of abuse and could describe the signs that may indicate abuse was taking place. Staff were also able to describe what action they would take if they suspected abuse and this followed local safeguarding procedures.

Staff received appropriate development. We found supervisions and appraisal were carried out and staff had received training appropriate to their role.

The service had a complaints procedure in place. Complaints had been recorded along with the action taken to resolve them. Records were easily accessible and up to date. However, we found some key information was not dated, or was missing from three of the four care files we looked at.

6, 12 February 2013

During a routine inspection

We spoke with six people who used the service or their relatives where they were not able to communicate themselves. They told us they were involved in the planning and assessment of their care. One relative said, 'Staff were very particular that my (relative's) wishes should be met'.

We looked at seven care plans and saw they contained personalised information about the care, treatment and support. We spoke with two healthcare professionals who were complimentary about the care people received. One said, 'The care they give is OK. I've not had any complaints'. People we spoke with told us staff were able to meet their needs. One said, 'The care I receive is extremely good'.

Staff were unable to demonstrate a sound understanding of safeguarding principles or the mechanisms for reporting abuse. Safeguarding training was not up to date, and guidance was not immediately available.

We looked at three staff training files and saw that appropriate checks had been undertaken before people started work. Staff were suitably qualified and experienced.

The provider had an effective system to assess and monitor the quality of service people received. One person said, 'They're always asking me if everything is alright'.

People's personal records including medical records were accurate and fit for purpose. Some policies relating to the management of the service were not immediately available and complaints were not recorded.