Background to this inspection
Updated
23 January 2024
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection team consisted of 3 inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post. However, during the inspection both the registered manager and the assistant manager left their posts.
Notice of inspection
The inspection was unannounced.
What we did before the inspection
We reviewed information we held about the service to plan our inspection. We sought feedback from the local authority and professionals who work with the service.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection we spoke to 7 staff, 4 service users and 2 professionals. We reviewed medicine records, care plans, risk assessment, recruitment files, governance information and policies and procedures.
We used all this information to plan our inspection.
Updated
23 January 2024
About the service
Dolphin Healthcare Wiltshire is service that domiciliary care agency that provides care at home to young people and adults. At the time of our inspection there were 24 people using the service.
People’s experience of using the service and what we found.
Not all risks people faced had been identified, assessed or mitigated, which did not promote safety.
People were placed at increased risk of harm by care plans which lacked detail to provide guidance for staff and ensure consistent support.
The electronic recording system did not always work which meant staff could not always access information needed to support people safely.
Medicines were not always managed safely; staff were administering medicines they were not trained to administer which could place people at risk of harm. Medication records were not complete or accurate and systems had not identified this.
People were not always supported in a person-centred way; staff did not understand people’s needs and did not engage well with them.
Staff were not always recruited safely, recruitment records showed that not all references were obtained and work histories were incomplete.
Governance systems were not in place or effective to keep people safe and make sure they received good care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The service was registered with us on 4 October 2023, and this is the first inspection.
Why we inspected
The inspection was prompted by concerns received about the safe provision of services. A decision was made for us to inspect the domains of safe and well led to examine those risks.
During the inspection we found there was a concern with the service, so we widened the scope of the inspection to include caring, responsive and effective.
Enforcement
We have identified breaches in relation to Regulations 9, 12 and 17 of the Health and Social Care Act 2006 (Regulated Activities) regulations 2014.
Please see the actions we have told the provider to take at the end of this report.
Follow up
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 do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this time frame and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.