Archived: Duty of Care 24-7 Ltd

Updated 21 June 2019

The inspection:

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

Inspection team:

This inspection was completed by one inspector.

Service and service type:

This service is a domiciliary care agency. It provides personal care to people living in their own homes.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. In this service the registered manager was also the provider.

Notice of inspection:

We gave the service 1 days’ notice of the inspection site visit because it is small, and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 17 April and ended on 30 April 2019. We visited the office location on 17 April to see the manager and office staff; and to review care records and policies and procedures. We concluded our telephone calls to people and staff on 30 April 2019.

What we did:

Before the inspection, we did not ask the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. However, the provider was given the opportunity to tell us all about the service and we took this into account when we made judgements in this report.

We reviewed the information we held about the service. We also contacted health and social care commissioners who place and monitor the care of people using care services, the local authority safeguarding team and Healthwatch England, the national consumer champion in health and social care to identify if they had any information which may support our inspection.

During our inspection, we spoke with one person who used the service, two members of care staff, one office staff and the registered manager.

We reviewed the care records for four people and three staff files. We also looked at other information related to the running of and the quality of the service. This included quality assurance audits, training information, staffing rotas, and arrangements for managing complaints. After the initial feedback, the registered manager sent us additional documents to help us conclude our inspection.

Updated 21 June 2019

About the service: Duty of Care 24-7 Ltd is a domiciliary care agency supporting people with their mental health and personal care needs. At the time of inspection, five people were receiving support with their personal care. Not everyone using the service receives a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People’s experience of using this service:

People’s experiences of the service were positive. However, the systems that were in place to ensure and review if the service provided good quality care required improving. Improvements were required to the auditing of the service, to review the quality of care people received. Effective auditing systems were not in place and there were no opportunities for people to review the service they received.

Staff did not know how to report safeguarding concerns to an external agency and improvements were also required to the recruitment procedures of new staff. Whilst training had improved since the last inspection, further improvements were required to ensure staff understood people’s specific care needs, particularly in relation people’s mental health needs.

We found improvements were required to people’s care plans to ensure they provided enough guidance to staff about supporting people with their care and achieving their goals. There were no plans in place to ensure people were given the opportunity to discuss end of life care.

People told us staff treated them well and respected their decisions. People were involved in decisions about their care and staff were knowledgeable about people’s preferences. The service was flexible to meet the changing needs of people that used the service and staff were respectful of people and their needs.

We have made a recommendation for the provider to provide staff with training about the specific mental health care needs of people using the service.

Rating at last inspection: Requires Improvement (published 13 June 2018). At the last inspection, there was a breach of Regulation 18: Staffing of the Health and Social Care Act 2018 (Regulated Activities) Regulations 2014 (Part 3). At this inspection we found improvements had been made and the service was no longer in breach of this regulation. However, this is the third inspection that the service has been rated as Requires Improvement and the CQC will be working with the provider to review how the required improvements can be made and sustained.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Enforcement: We found the provider to be in breach of one of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3), Regulation 17: Good governance.

Follow up: The provider will be instructed to provide an action plan and we will be meeting with the provider to review how they can make the required changes to achieve and sustain a Good rating.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk