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Archived: Dignity Care (York) Limited Requires improvement

The provider of this service changed - see old profile


Inspection carried out on 28 June 2016

During a routine inspection

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 carried out on 6 January 2014

During a routine inspection

We spoke with three people who received care and three relatives [referred to as people in the report]. We also spoke with three members of staff and the two providers, one of whom was the registered manager.

All the people we spoke with confirmed they or their representatives had been involved in planning their care.

People expressed a high level of satisfaction with the care provided. Comments from people included: �They are amazing,� �Exemplary,� and �They are what they call themselves; they treat people with dignity and respect.�

Staff received appropriate professional development. All of the people we spoke with told us they thought the staff were well trained. People told us �I have seen and heard the staff with X and they are amazing,� �They crouch down to talk at Y�s level. They behave in such a dignified way,� and �They are so professional but in such a friendly and kind way.�

We asked people who received care in their home and their relatives whether they felt safe when care staff went into their homes. All the people told us they felt safe and had no concerns regarding feeling safe. Comments from people included: �The arrangements they [the providers] have in place are geared towards making people safe� and �X feels totally safe when the staff visit; they actually look forward to the visit.�

Arrangements were in place for obtaining feedback from people about their satisfaction with the quality of care they received.

Inspection carried out on 13 December 2012

During a routine inspection

Before people received any care or treatment they were asked for their consent and the service acted in accordance to their wishes. We spoke with two people receiving care in their home and two relatives. They told us that staff spoke with them about the care and support that they were receiving.

We did not observe any direct care being provided but spoke with people via the telephone. They told us that they were very happy with the care and that they received the care and support that was agreed in their care plan. Comments from people included �We couldn't do without them", "It's excellent care" and "We are absolutely satisfied."

All the people receiving care told us that they felt safe when carers went into their home.

The people we spoke with told us that they would tell the managers if they needed to make a complaint. One person said "If there is a problem I just phone and it is sorted but there are no real issues." People said they had no major complaints.

Appropriate checks were undertaken before staff began work. We reviewed three staff files and viewed the recruitment procedures during our visit to the office for the service. All the files contained the relevant pre-employment checks which included references, enhanced Criminal Records Bureau (CRB) check and Independent Safeguarding Authority (ISA) First Check. This meant that the provider was assured that staff were not barred from working with adults or children.

Inspection carried out on 22 December 2011

During an inspection looking at part of the service

We contacted people who use the service, by telephone, and asked them about their care records. We asked whether they knew about the records, if they thought they were accurate and up to date and where they were kept. One person told us, "The carers' fill them in when they have been, I don't read them myself but they are in the house if I want to." Another person said his relative was well looked after and that "Records are kept of what she needs but we don't bother with them."

In conversation, one person told us, "I had the opportunity to change to another agency but I want Dignity to look after me. I am more than happy with the care." Another person said, "The care is excellent, it has been from day one. We couldn't find better, it's lovely care." During the visit to the office, a relative called in. She told us, "If it hadn't been for Dignity I couldn't have kept my mother at home for 16 months or gone on holiday." She said, "The carers and owner go the extra mile to make sure people are looked after properly and used to keep me informed by text message, if I was away on holiday."

Inspection carried out on 21 September 2011

During a routine inspection

People we spoke with by telephone told us they were very satisfied with the service they received from Dignity Care (York) Ltd. One person told us �I am very happy with Dignity. The carers are very kind and know what they are doing�. They added that although the carers helped them with showering, they were the one who decided which clothes to wear. Another person commented that the care they received was fine and carers were always very polite and respectful. They commented that Dignity provided �200% better care� than their previous care provider. The third client we spoke with told us they were �very impressed� with the service and thought it was �very, very good�.