23 May 2016
During a routine inspection
Direct Health (Oldham) is a domiciliary care service registered to provide personal care to adults living in their own homes in Oldham and Rochdale. The service’s office is based in the Glodwick area of Oldham. At the time of our inspection, the service was providing personal care and support to 100 people and employed 44 members of staff. At the time of our inspection some staff and people using the service had transferred to Direct Health (Oldham) from another provider.
We lase inspected this service in October 2014, where the service was found to be meeting the standards assessed.
The service had a registered manager. 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 registered with Care Quality Commission in February 2016.
We found four 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 back of the report.
People were not protected against the risks associated with the management of medicines. Medication records did not contain important information about the medicines that people were taking and care plans did not show what support people needed with their medicines. This meant that there was a risk that people might not receive the medicines they needed as prescribed by their doctor.
The provider did not have adequate systems in place to ensure the safe handling, administration and recording of finances to protect people from financial abuse.
Risk assessments for people who received a service were incomplete or lacked detail. Where risk assessments were in place they did not provide detailed person specific information to mitigate identified risks. We saw no risk assessments identifying hazards in the environment such as working in people’s home or when out in the community.
Improvements needed to be made to ensure all staff receive regular supervisions and appraisal.
Refresher training had been identified for all staff and a twelve-month training plan was in place. All new staff undertook an in-house induction programme when they started work at the service including the ‘Care Certificate’.
People had their needs met by sufficient numbers of deployed staff. An ongoing recruitment plan was in place and additional staff had been employed to manage business growth.
Where the service supported people to eat and drink we found care plans were in place for staff to follow. However, the care plans did not identify if the person was at risk of malnutrition and what steps were to be taken to mitigate any risks. We have made a recommendation that where people require support with their nutritional needs, risk assessments are in place clearly detailing the steps to be taken to mitigate risks.
People told us staff were caring and respected their privacy and dignity.
The service had safeguarding and whistleblowing procedures in place and care staff were aware of their responsibilities.
Staff told us that they sought people’s consent prior to providing their care. Where people were assessed not to have the capacity to consent to their care and treatment. There was a record of how the care provided had been agreed.
People's needs had been assessed prior to the commencement of support. Information about peoples likes dislikes and preferences were included so staff had the relevant information to assist them when supporting the person. However, the care plans we reviewed were basic and lacked detailed information about the person’s needs, their past history likes and dislikes. Care staff told us that not all the relevant information was available to them in the care plans. We have made a recommendation about care records needing to be more person centred.
There were some systems in place to assess and monitor the quality of service provided. People told us that they completed a questionnaire to provide feedback on the service.
Staff told us that they found the new management approachable and felt that they were listened to.