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Dynasty Care Limited

Overall: Good read more about inspection ratings

15 Nelson Road, Whitton, Twickenham, TW2 7AR (020) 8898 6476

Provided and run by:
Dynasty Care Ltd

Latest inspection summary

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Background to this inspection

Updated 23 October 2018

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 on 25 September 2018 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.

One inspector undertook the inspection. We reviewed the notifications we had received from the service, records of safeguarding alerts and previous inspection reports.

Before the inspection, the provider completed 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.

During the inspection we spoke with the registered manager and the registered provider. We reviewed the care records for three people using the service and the employment folders for three care workers. We looked at records and policies relating to the management of the service including medicine administration records (MAR).

We spoke with four people who used the service and three family members. We also spoke with five members of staff.

Overall inspection

Good

Updated 23 October 2018

We undertook an announced inspection of Dynasty Care Limited on 25 September 2018.

Dynasty Care Limited is a small service which provides personal care and support services to people living in their own homes, including older people with dementia. At the time of our inspection the service provided support to 10 people.

At the previous inspection on 31 July 2017 we found that the service was not meeting all the quality standards and was rated "Requires Improvement” in the key areas of safety, effectiveness, being responsive to people’s needs and in the management and leadership of the service. The inspection rated the service overall as “Requires Improvement”.

We asked the service to provide us with an action plan for improvement and we monitored improvement during this inspection. At this inspection we found that the provider and registered manager had made the necessary improvements to their service.

At the previous inspection we found that the provider did not have suitable arrangements to protect people against the risks associated with the management of medicines. The registered manager had not ensured that staff follow National Institute for Health and Care Excellence (NICE) guidelines for the recording of medicines taken or refused which meant that the registered manager could not be sure that medicines were administered safely.

At this inspection we found that records of medicines were accurately maintained and that staff were confident in administering medicines because they had had adequate training in medicines administration. People and relatives confirmed that medicines records were kept and that they received their medicines as prescribed.

At the previous inspection we found that the registered manager did not have systems in place to ensure care staff received appropriate or regular training and support to effectively meet people’s needs.

At this inspection we found that improvements had been made to the planning and recording of staff supervision and training. Records indicated that regular supervision was held and was carried out both in the form of individual conversations and in the carrying out of spot checks. There were records of up to date mandatory training and refresher training for staff.

At the previous inspection we found that the provider did not always follow the service’s complaints policy and procedure correctly, which had led to some people’s complaints not being appropriately responded to.

At this inspection we found that there were records of any issues or concerns and recorded details of how people were responded to, together with checks that people were satisfied with the outcome. People and their relatives expressed satisfaction with the way they could raise any issues with the registered manager or provider.

At the previous inspection we found that the service did not have good governance arrangements in place to assess, monitor and improve the quality and safety of the services provided. Audits and checks by the registered manager had not always been carried out, such as regular supervision, spot checks to monitor quality or developing quality assurance systems to receive and act on the feedback of people who used the service.

At this inspection we found that the registered manager had improved their good governance arrangements. These included regular telephone contact with people, spot checks, surveys and recorded audits of the service.

At the time of the inspection, 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.

People were encouraged to make their own choices and maintain their independence. They were included in risk assessments to ensure that care was provided in a safe manner. People received personalised care in accordance with care plans which included risk assessments and instructions on how people preferred their care to be given. Staff had received basic training in and were aware of, policies and procedures designed to keep people safe, including safeguarding people from abuse, the use of hoists and the management of medicines.

There were systems in place to guide staff in reporting any concerns. The registered manager and care staff were aware of the Mental Capacity Act 2005 (MCA) code of practice.

People were supported to eat healthily where this was part of the agreed plan of care. In addition, care staff brought any concerns regarding nutrition or fluid intake to the attention of the manager so that they could be raised with relatives if necessary. People received the support they needed to stay healthy and to access healthcare services.

People and their relatives were satisfied with their service. Feedback from people was positive throughout. People felt that they were with a care provider they could trust and they liked their care workers who were described as kind, caring and respectful. They told us their needs were met and the way in which they were cared for reflected their preferences. People were involved in planning and reviewing their own care.