Archived: Derbyshire Care Services

Updated 10 August 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place over 20, 21, 22 and 30 June 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to visit the office, talk to staff and review records. The inspection team included two inspectors and one expert by experience who spoke with people on the telephone. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we looked at all of the key information we held about the service. We asked the service to complete a provider information return (PIR). This is a form that asks the provider to give us information about the service, what they do well, and what improvements they are planning to make. This was returned to us by the service.

In addition, during our inspection spoke with eleven people and five relatives on the telephone. We also spoke with the registered manager, the nominated individual and the director. We spoke with the training manager and four care staff.

We looked at four people’s care plans and reviewed other records relating to the care people received and how the agency was managed. This included risk assessments, quality assurance checks, staff training and recruitment records.

Updated 10 August 2017

This inspection took place over 20, 21, 22 and 30 June 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to visit the office, talk to staff and review records. Phone calls to people were completed on 20 and 21 June 2017 and we visited the premises and spoke with staff on 20 and 22 June 2017. Phone calls were made to more staff on 30 June 2017.

The service provides personal care and support to people who live in their homes in and around the Derby area. The service operates from two locations, one at Burton Road and one at Shardlow Road. This inspection relates to the service provided from Shardlow Road to people living in and around the south of Derby; at the time of this inspection 117 people received the regulated activity of personal care from the Shardlow Road location.

The service is required to have 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.

Although people felt care staff helped them reduce risks on a day to day basis, care was not always safe as risk assessments and care plans were not always updated in a timely manner. Nor were risk assessments always complete. In addition, risk assessments were not in place for all areas of risk to a person and to staff.

Not all steps had been taken to check people recruited to work as care staff were safe to do so. Not all pre-employment checks designed to help providers make safer recruitment decisions had been completed as required.

Although staff told us they were confident at identifying some of the signs that could indicate abuse to a person and told us they knew how to report their concerns, we found the training material they were given did not reflect the current types of abuse recognised in safeguarding practice. Not all allegations of abuse had been sent to the local authority as safeguarding referrals.

People did not experience missed calls, however some people experienced late calls and people did not always get a phone call to let them know if a call had been delayed. People did not receive information on what care staff would be supporting them each week. People told us they appreciated regular care staff; where people did not receive regular care staff they felt their care was compromised in a variety of ways. There were a sufficient amount of staff to attend to calls, however staff were not always deployed in ways to ensure people felt safe and knew who was coming into their home.

The MCA had been considered when assessing people’s capacity to consent to their care. However where people were identified as not having capacity there were no records of best interest decision making to show the care provided was in the person’s best interests. Staff knowledge on the MCA varied and not all staff had been trained in this area. Records showed training in other areas relevant to people’s care had not been consistently completed by all staff.

Records of people’s care were not always accurate, complete or up to date. Care plans and risk assessment records were not audited to ensure the quality and safety of records.

Statutory notifications were not always submitted as required. Not all actions were taken to ensure improved services to people. In addition, people had been asked for their views; however they were not informed of what actions would be taken to improve the service based on their feedback. People had not always experienced improvements as a result of sharing their views.

People felt they could complain and if they had done so they felt they had received a response and things had improved. Whilst we saw actions were taken to people’s individual complaints, there was no evidence to show how actions were being taken to improve the service for people based on themes emerging from people’s complaints.

People told us they felt involved at the start of their support when the care plan was developed with them. However some people told us, and records confirmed, they did not always contribute to on-going reviews of their care.

People told us they had mixed experiences of being supported to access other healthcare services as required.

Guidelines were in place and followed to ensure medicines management and administration was safe.

Staff told us they felt supported by the registered manager and received feedback that helped them identify how to improve their practice.

People received care to enable them to have sufficient food and drink of their choice.

People told us most care staff were friendly and respected their privacy and promoted their dignity and independence. People were happy care staff were respectful to their home. People’s cultural views and values were known and respected.

There was a registered manager in place at the time of the inspection. Staff told us they found the registered manager and director approachable. People and their families told us they had no problem contacting the office with any queries. Staff told us they enjoyed their job and had opportunities to meet with the registered manager to share their views.

Spot checks were made on the care provided by staff. Phone calls were made to people when they first received care from Derbyshire Care Services and for a period of time thereafter to check they were happy with the service received.

At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we asked the provider to take at the end of the full version of this report.