We carried out a review of the data available to us about Sunbury 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 Sunbury, you can give feedback on this service.
Direct Independent Care Limited is a domiciliary care agency providing personal care to 15 people aged 65 and over at the time of the inspection, this included ‘live-in care’. At the last inspection the service was supporting 23 people.
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.
People’s experience of using this service and what we found
Improvements had been made since the last inspection. This included new risk assessment processes. This also included new and retrospective pre-assessments completed to ensure the service could meet people’s needs.
Management had also introduced a new quality assurance audit system which identified any needs or concerns that required action. We saw from records any concerns identified were being actioned.
People were being supported safely with their medicines, and new audits for medicine administration records (MARs) had been introduced. This ensured that people were receiving their medicines at the correct time, and any errors were identified quickly. People were kept safe from the risk of infection.
People told us that they were well supported by kind and caring staff who were competent and well trained in delivering care. Training records supported this, showing that all staff were up to date with mandatory training. People were kept safe by staff who understood different types of abuse and how to report any concerns correctly.
Staff were supported by a management team who completed regular supervision and sought regular feedback from staff. This ensured staff were comfortable to carry out their role and confident to raise any issues. Staff were recruited safely and there were enough staff deployed to keep people safe and meet people’s needs.
Staff respected people’s privacy and dignity and encouraged independence where appropriate. People told us they were treated with respect and kindness.
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 to express their views and there was a clear complaints policy that was available to every person using the service. Where people had complex communication needs staff supported them with different communication aids, this was all documented in individual care plans.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 05 December 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
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.
Sunbury is a domiciliary care agency that provides care to people living in their own homes as well as ‘live-in’ care. It provides a service to older people, some of whom may have a physical disability or are living with dementia. At the time of our inspection the service provided a regulated activity to 23 people. At the previous inspection the service was rated Good.
There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (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.
People told us they felt safe, however risks to people were not always fully assessed and did not provide clear guidance to staff to help reduce the risk of harm to people. Accidents and incidents were not always being recorded by staff. When incidents did occur, there was no analysis being completed to reduce the risk of them happening again. People received their medicines however they were not always managed safely. Medicines Administration Records were checked but not routinely audited to identify errors.
When people first started using the service there was not always a pre-admission assessment completed. This meant there was a risk that the service might not be the most suitable placement for them.
Care plans did not fully reflect people’s needs and interests and had not been reviewed regularly to ensure they were up to date. End of life care planning was not always being completed. Whilst there had been no complaints since the last inspection the complaints policy needed to be updated so people would be aware who they could raise concerns with and a timescale for response.
Audits of the quality of the service were not always taking place to identify areas for improvement and to provide assurance that staff were staying for the correct time at visits. Feedback from people was received and an annual questionnaire completed however the results were not always acted upon.
There were sufficient numbers of staff working at the service and recruitment processes were robust. Staff understood what they needed to do to protect people from the risk of abuse. Staff followed safe infection control practices.
The principles of the Mental Capacity Act were being followed and staff ensured that they gained consent from people before delivering care. Staff had the necessary training and supervision required to carry out their role effectively. People and relatives told us staff were competent and knew people’s needs well in order to deliver the care required. Staff worked with health care professionals to ensure that people were supported with the health care needs. This included being supported with their food and hydration needs.
People and relatives felt that staff were very caring and respectful, treated them with dignity and upheld their privacy. People felt that staff assisted with their independence and included them in any decision-making. People and relatives developed positive relationships with staff.
People, relatives and staff thought the leadership of the service was good and were confident any concerns would be acted upon where necessary. Staff told us they felt supported and valued and they understood the need to provide a good service to people. The service worked closely with other agencies outside the organisation. The registered manager knew what they needed to do should there be a notifiable incident.
There were three breaches of regulations. See the end of the report for actions that we have taken.
This was an announced inspection that took place on 3 November 2015.
The agency provides personal care to people living in their own homes. It is located in the Twickenham area. There were 24 people using the service.
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 and associated Regulations about how the service is run.
This was the first inspection since a move to new premises and met the regulations.
People said the service provided was what they required and met their expectations. The designated tasks were carried out to their satisfaction, they felt safe and the staff team and organisation really cared. They thought the service provided was safe, effective, caring, responsive and well led.
The service kept up to date records that covered all aspects of the care and support provided for people, the choices they had made and identified and met their needs. The information was clearly recorded, fully completed, and regularly reviewed. This enabled staff to perform their duties well.
Staff where knowledgeable about the people they supported, the way they liked to be supported and worked well as a team. They provided care and support in a professional, friendly and skilled way that was focussed on the individual and their needs. They were well trained, knowledgeable and accessible to people using the service and their relatives. Staff thought the organisation was a good one to work for and they enjoyed their work. They had access to good training, support and there were opportunities for career advancement.
People and their relatives said they were encouraged to discuss health and other needs with staff and had agreed information passed on to GPs and other community based health professionals, if required. Staff protected people from nutrition and hydration associated risks by giving advice about healthy food options and balanced diets whilst still making sure people’s likes, dislikes and preferences were met.
The agency staff knew about the Mental Capacity Act and their responsibilities regarding it.
People said the management team and organisation were approachable, responsive, encouraged feedback from them and consistently monitored and assessed the quality of the service provided.