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Inspection Summary


Overall summary & rating

Good

Updated 28 September 2018

This inspection took place on 3 and 5 July 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service. At the time of the inspection Daryel Care provided domiciliary care and support for 57 people in their own home. The service worked primarily with older people living with dementia and a small number of people with physical impairments.

At our last inspection on 31 May and 1 and 2 June 2017 the service was not meeting the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found breaches of Regulations 12 and 18 which related to recording risk assessments and recording medicines provided as well as professional development opportunities not being made available for care workers. Each of these areas had been addressed and the provider was now complying with these regulations.

There was a registered manager in post. A registered manger 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 law; as does the provider. The registered manager was present during the inspection.

Risk assessments had improved and provided care workers with guidance on how to mitigate people’s individual personal risks. Risks had been clearly identified and risk reduction measures were outlined.

People we spoke with told us they received their medicines safely and on time. The service was now keeping records of the assistance people received with their medicines or lists of medicines which each of these people took. These medicines records were being audited regularly to ensure that medicines were managed safely.

Care workers told us that they felt supported by the manager and other senior care workers at the agency and they were offered the opportunity to meet and discuss their work regularly through supervision. Care workers appraisals were taking place as well as training and development needs being offered for care workers.

New care workers completed an induction. The induction policy stipulated that all new care workers were expected to achieve the care certificate within twelve weeks of employment and this was being complied with.

The service operated safe staff recruitment procedures and ensured that all staff were suitable for the role before beginning any care work.

Procedures relating to safeguarding people from harm were in place. Care workers we spoke with understood what to do and who to report it to if people were at risk of harm. Care workers understood the systems in place to protect people who could not make decisions and were aware of the legal requirements outlined in the Mental Capacity Act 2005.

People were involved in planning their care and had regular reviews to gain their opinion on how things were. Care plans were person centred and included suitable information on how people wanted their care to be delivered as well as their likes and dislikes.

People and relatives were provided with information on how to make a complaint and their views were obtained and acted upon. People were treated with dignity and respect and trusted the care workers that supported them.

At this inspection we found that the previous breaches of Regulations 12 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been complied with. There were no further breaches of regulation identified. Please refer to the main body of this report for further details.

Inspection areas

Safe

Good

Updated 28 September 2018

The service was safe. Risk assessments had improved and now provided care workers with appropriate guidance on how to mitigate specific risks of falls and trips for some people.

The provider now kept records of assistance provided with medicines and details of medicines taken for all people that required assistance.

The provider followed safe staff recruitment practices.

Care workers were trained about keeping people safe from harm or abuse and those we spoke with had a good understanding of how to do this. People received a continuity of care and usually had the same care workers visiting them.

Effective

Good

Updated 28 September 2018

The service was effective. Care workers supervision and appraisals had improved. The provider had recognised and acted on this since our previous inspection.

Care workers received regular training and an induction before commencing their work and all care workers had either completed, or were completing, the care certificate.

Care workers were aware of the Mental Capacity Act 2005 (MCA) and how this impacted on the care that they provided for people.

When required as a part of their care and support needs care workers supported people to eat and drink so that their dietary needs were met.

Caring

Good

Updated 28 September 2018

The service was caring. People were supported and care workers knew people well and could tell us about the people they supported.

People were treated with respect and believed that care workers maintained their privacy and dignity.

People were encouraged and supported to have input into their care and their views were respected.

Responsive

Good

Updated 28 September 2018

The service was responsive. Care was person centred and planned in consultation with them, which people and relatives confirmed.

Care workers were knowledgeable about people as unique individuals and knew about people�s interests and preferences.

People knew how to make a complaint. There was an appropriate complaints procedure in place and the provider responded to complaints and provided full explanations and apologies as necessary to people.

Well-led

Good

Updated 28 September 2018

The service was well led. Auditing of medicines management or people potentially coming to harm due to risk had improved significantly. The provider audited these, and other systems, to ensure that the service was working effectively.

Care workers meetings were taking place, which we confirmed by looking at care workers meeting minutes.

Care workers told us there was good support from senior colleagues and guidance was readily available from the manager and other senior care workers.

The service monitored the care provided to people. The provider had taken the necessary steps to improve the level of spot check monitoring to ensure continuity and appropriate care delivery.

People�s views were obtained and were acted upon.