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Day and Nite Services (Kingston) Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 1 April 2021

Day and Nite Services (Kingston) is a domiciliary care agency. At the time of our inspection they were providing help with personal care to 51 older people living in their own homes in and around South West London and Surrey. The agency also had a contract to provide regular one-to-one staff support to people living in a nursing home in Surrey.

21 additional people who used the service received help with tasks that were not related to personal care including, shopping, cleaning and welfare checks. The Care Quality Commission (CQC) only inspects where people receive personal care. Where they do, we also consider any wider social care provided.

People’s experience of using this service

Most people told us they were satisfied with the standard of care and support provided by this domiciliary care agency. People typically described the staff as “caring”. However, we found evidence during our inspection of multiple breaches of regulation and the need for this provider to make improvements.

The provider’s recruitment procedures to check the suitability and fitness of new staff for their role were not consistently or safely applied. This meant people using the service had been placed at unnecessary risk of harm of receiving personal care and support from staff who were not properly vetted and therefore might not be ‘fit’ for their role.

The provider had failed to always notify the CQC without delay about the occurrence of incidents that had adversely affected the health, safety and well-being of people using the service. This placed people at risk of harm because the CQC was not aware of how the provider had managed such incidents and were keeping people safe.

The provider had established governance systems in place to assess and monitor the quality and safety of the care people received however, we found these processes were not always operated effectively. This is because they had failed to pick up a number of issues we identified during our inspection.

In addition, we have made a recommendation about staff being entitled to sufficient uninterpreted time off without working between their scheduled visits and/or shifts.

We also received mixed feedback from people about staff time keeping, with approximately a third expressing dissatisfaction with staff arrival times and missed visits. We discussed this staffing issue with the managers at the time of our inspection who were aware this was something they needed to improve. Managers confirmed they were in the process of introducing a new electronic call monitoring (ECM) system to replace their existing one, which they were confident would significantly improve how they monitored and managed staff punctuality and attendance.

Despite our findings, we found people continued to receive personal care and support from staff who knew how to manage risks and keep them safe. Staff followed relevant current best practice guidelines regarding the prevention and control of infection. People continued to receive their prescribed medicines as and when they should.

The provider ensured staff had the right levels of training and support they needed to deliver effective home care to people.

The provider promoted an open and inclusive culture which sought the views of people using the service, their relatives and staff. The provider worked in partnership with other health and social care professionals and agencies to plan and deliver people’s packages of care and support.

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 good (published 27 August 2019).

Why we inspected

We received concerns in relation to the management of staff recruitment. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

We also used a targeted approach to look at specific concerns we had about staff training and support under the Key Q

Inspection areas

Safe

Requires improvement

Updated 1 April 2021

The service was not always safe.

Details are in our safe findings below.

Effective

Good

Updated 1 April 2021

At our last inspection we rated this key question good. We have not reviewed the rating at this inspection. This is because we only looked at the parts of this key question we had specific concerns about.

Caring

Good

Updated 1 April 2021

Responsive

Good

Updated 1 April 2021

Well-led

Requires improvement

Updated 1 April 2021

The service was not always well-led.

Details are in our safe findings below.