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Archived: Dignity Care (York) Limited Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 10 August 2016

We undertook an announced comprehensive inspection on Tuesday 28 June 2016. We gave the provider 48 hours' notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service and we needed to be sure that someone would be at the agency office that could assist us with the inspection.

This service was registered by CQC on 12 June 2011. A previous inspection had been completed on 06 January 2014 and the provider was found to be compliant in the areas we inspected at that time.

Dignity Care (York) Limited is registered to provide personal care for Older People and people with a Physical Disability. At the time of our inspection, 27 people received a personal care service. The service provides domiciliary care and support services from the registered office location, on the outskirts of the City of York.

The registered provider is required to have a registered manager in post and on the day of this inspection, there was a registered manager registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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.

Care workers were able to discuss signs of abuse and how to report their concerns. However, management of training in safeguarding for care workers was ineffective and not robustly managed or recorded. Safeguarding policies and procedures were available for care workers to read however, they required updating.

Other Quality Assurance checks included an annual survey sent to service users. We saw this was not analysed and there was no evidence of how the service used feedback from Quality Assurance to continually evaluate and improve the service provided or where this was recorded. We concluded that although there were some Quality Assurance checks in place these were not robustly implemented across the service to ensure they could be used to drive improvement.

The registered provider did not have a dedicated file or procedure to record and manage accidents and incidents. This meant that the registered provider could not demonstrate how they learned from such events to minimise re-occurrence.

The registered provider had a file with compliments and they told us these were fed back to the care workers. This showed that the service actively sought peoples feedback however, it was not evident that complaints would be addressed with actions and outcomes recorded.

The registered provider had a training record to manage training for care workers. However, at the time of our inspection the registered manager told us and we saw that the training record was not in use and had not been updated. Procedures in place to manage training for care workers including the induction programme were ineffective and it was not clear if they had the appropriate skills to undertake their role. We spoke with care workers who told us they did not have regular documented supervisions or reviews. We saw these were not recorded and it was not clear how their capability was monitored by the registered provider. The registered manager told us they did not have regular staff meetings and that information was shared with care workers using weekly emails and text messages.

Care plans we looked at contained up-to-date risk assessments for their homes, environments and for the individuals and these were reviewed and updated. This meant the registered provider had procedures in place to recognise the importance of risk management to help care workers deliver care and support in a safe way to people.

The registered provider recorded appropriate recruitment checks and these were completed before they worked alone with people. This helped the registered provider to ensure people employed were of suitable character

Inspection areas

Safe

Requires improvement

Updated 10 August 2016

The service was not always safe.

Care workers were able to discuss signs of abuse and how to report their concerns. Safeguarding training was not well managed or recorded and policies and procedures required updating.

Appropriate recruitment checks were completed to ensure people employed were of suitable character to work with vulnerable people.

Policies and procedures were in place and followed to ensure people received their medication in a safe way.

Accidents and Incidents were not recorded in a dedicated file and there was no documented of evidence of how the registered provider learned from these events.

Effective

Requires improvement

Updated 10 August 2016

The service was not always effective.

Procedures in place to manage training for care workers including induction were ineffective and it was not clear they had the appropriate skills to undertake their role.

Care workers did not have regular documented supervisions or reviews and it was not clear how their capability was monitored.

The registered provider was working under the Mental Capacity Act 2005, people were supported to make informed decisions where ever possible and care plans were signed by people to demonstrate they had understood and agreed to the content.

Caring

Good

Updated 10 August 2016

The service was caring.

People received support and care from care workers who understood the importance of treating people with dignity and respect.

Care workers understood how to respect people's confidentiality.

Care workers were kind, efficient and caring and showed they cared for the people they were supporting.

People were involved in planning their care and support and were given information about advocacy services.

Responsive

Good

Updated 10 August 2016

The service was responsive.

Care plans gave staff detailed information on how to support people and keep them safe and the plans were reviewed and updated regularly.

People were supported to undertake activities and to access the community if they requested that service.

People and their relatives knew how to complain if they needed to however it was not evident that complaints would be addressed with actions and outcomes recorded.

Well-led

Requires improvement

Updated 10 August 2016

The service was not always well-led.

Management was praised by people who used the service and by care workers for their involvement in people's care and support.

Policies and procedures in place for the management and recording of employee information were ineffective.

Care workers understood their roles and responsibilities.

There was some evidence of Quality Assurance checks in place but these were not robustly implemented across the service to ensure they could be used to drive improvement.