We carried out a review of the data available to us about DCC High Peak Home Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about DCC High Peak Home Care, you can give feedback on this service.
DCC High Peak Home Care is a domiciliary care agency. It provides care to people living in their own houses and flats and also at two extra care facilities in the High Peak area of Derbyshire. The service supports younger adults, older people, people living with dementia and people with physical disabilities living in their own homes. Most people received a short-term reablement service following a period of hospitalisation or illness. At the time of the inspection, there were 92 people using the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People received safe care and support. Staff had received training on safeguarding adults and were aware of their responsibilities to protect people from avoidable harm. Risks associated with people’s individual needs had been assessed and planned for. Up to date guidance was available for staff to follow. Learning from mistakes took place to reduce the risk of recurrence.
People told us they were happy with their care and felt involved in care planning and delivery. People told us they received their calls on time and by staff who they felt were suitably qualified. Care plans were personalised and contained person-centred information. There were sufficient staff to meet people’s individual needs. People received support in line with national best practice guidance, in the administration of their medicines. Safe recruitment procedures were used, to support in making recruitment decisions.
People’s care and support reflected their individual assessed needs. Where people received support with reablement needs, choice and independence were promoted. The provider understood that staff required mandatory training, and this was made available to staff, by provision of online workbooks and one to one training. Information was shared with external healthcare professionals, to support people with their ongoing healthcare needs.
People consistently gave good reports about the staff providing their care. They described staff as being caring and patient. People told us they were involved in decisions about the care and support they received. People received care and support that respected their individual preferences and lifestyle choices.
Roles, responsibility and accountability arrangements were made clear. Systems for identifying, capturing and managing risk were effective, with regular reviews of care plans, daily logs and medicine records. A complaints procedure enabled people to raise any complaints and any received were fully investigated. Quality assurance systems and processes were used to monitor quality and safety. The registered manager was aware of their registration regulatory responsibilities. Staff were positive about the leadership and support provided by their managers.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People told us they were asked for their consent prior to any services being provided. The provider was working within the Mental Capacity Act (MCA) and we saw where capacity assessments had been completed if there was any doubt that people were unable to make their own choices.
Rating at last inspection and update
The last rating for this service was requires improvement (published 11 September 2021). At the last three inspections, breaches of Regulations were found. The provider had completed an action plan to show what they would do and by when to improve. At this inspection we found enough improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since the last inspection. During this inspection the provider demonstrated that significant improvements have been made. Therefore, this service is no longer in Special Measures.
Why we inspected
We carried out an announced focused inspection of this service on 11 January 2022. We undertook this focused inspection to check to check whether the Warning Notice we previously served in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met and to confirm they now met legal requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for DCC High Peak Home Care on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
DCC High Peak Home Care is a domiciliary care agency. It provides care to people living in their own houses and flats and within two extra care facilities in the High Peak area of Derbyshire. The service supports younger adults, older people, people living with dementia and people with physical disabilities living in their own homes. Some people received a short-term service following a period of hospitalisation. At the time of this inspection there were 118 people using the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Roles, responsibility and accountability arrangements were not clear. Systems for identifying, capturing and managing risk were ineffective, for example, medicine records and care plans were not routinely reviewed. People and staff told us the service was not well-led and they were not clear on who held managerial responsibility. People told us they were happy with their care and felt involved and included in care planning and delivery. However, staff consistently told us they did not feel listened to, valued or involved in the running of the organisation.
Assessment of risks to people’s safety were not always available or effective. There was a lack of up to date available guidance for staff to follow. People told us they received their calls on time and were supported by staff who they felt were suitably qualified. Accidents and incidents were reviewed, and outcomes recorded.
Care planning and reviews were inconsistent. Care plans contained person-centred information and people told us they felt involved in developing their own care, but some information in care plans was not up to date. People told us they knew how to make a complaint if they needed to and complaints we reviewed had been handled as per the provider’s policy.
The provider understood that staff required training, and this was readily available to staff. However, staff training was not always up to date or in line with best practice. Staff training records did not demonstrate that staff had completed mandatory training. However, people told us they felt staff were well trained and staff told us there was an abundance of training.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The provider was working in line with the Mental Capacity Act (MCA). People’s ability to make their own choices was assessed and respected. People told us staff always gained their consent before supporting them.
People consistently spoke highly of staff and told us they were kind and caring. People and their relatives said they were treated with respect and kindness by staff who were patient and respected their dignity. People said they formed close relationships with staff.
Rating at last inspection (and update)
The last rating for this service was Requires Improvement (published 12 May 2020). At the last two inspections, breaches of Regulations were found. At this inspection we have found the provider has not implemented enough improvement and remains in breach of Regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Special Measures:
The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.
Dales and North West Derbyshire Homecare is a domiciliary care agency. It provides care to people living in their own houses and flats and within two extra care facilities in the Dales, High Peaks and North West Derbyshire. The service supports younger adults, older people, people living with dementia and people with physical disabilities living in their own homes. Some people received a short-term service following a period of hospitalisation. At the time of this inspection 258 people were using the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
The provider did not have a clear overview of the service provided and quality checks were not always completed to improve the service. Quality monitoring was inconsistent and had not identified all the risks to people to ensure people’s health and wellbeing. The provider did not always understand the requirements of their registration and had been operating the service from a different address to the registered office.
Some staff had not had the opportunity to undertake the training they needed in order to care for people safely when they were discharged from hospital. Care plans and risk assessments had not always been reviewed to describe the actual care people received. People could retain their independence and manage their medicines. However, where support was given, accurate records were not always maintained to record the level of support people needed.
When people received short term care, care plans were completed from professionals outside of the service. Senior staff did not always review the suitability of their care in a timely manner to ensure this was effective in their home.
People’s health needs were met, and they had access to health care and social care services when necessary. People were happy with the staff that currently provided their care and had developed positive and caring relationships with people they clearly knew well. People were concerned the changes within the service would change this.
People made decisions about their care and were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests. People and staff were concerned the new changes would mean established relationships would not be maintained.
Staff had been trained in how to safeguard people from avoidable harm and were knowledgeable about the potential risks and signs of abuse. Safe and effective recruitment practices were followed to help make sure that all staff were of good character and suitable for the roles they performed at the service. The provider had a complaint’s policy and procedure and people were confident they knew how to raise any concerns. There were regular meetings for staff to share their opinions about the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Requires Improvement (Published 6 March 2019) and there were two breaches of regulation. The provider completed an action plan to show what they would do and by when to improve. At this inspection we found sufficient improvements had not been made.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Enforcement
We have identified breaches in relation to how the provider and the oversight of the service. Quality and safety checks were not always carried out.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Glossop DCC Homecare Services is a domiciliary care service providing personal care and support to people in their own homes. The office is based in the centre of Glossop. The service was providing personal care to 104 people at the time of the inspection.
People’s experience of using this service:
Quality assurance processes were in place but needed further development to ensure they were always effective in identifying areas for improvement promptly, as well as identifying trends. Errors in the recording of medication administration were not consistently identified by audit systems. These systems needed to improve to ensure safety and quality for people.
We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 related to the management of medicines and good governance. Details of action we have asked the provider to take can be found at the end of this report.
People were supported by skilled and competent staff but recent organisational changes meant that they were not always supported by staff that knew them well. People told us this had impacted negatively on the consistency of care.
Motivation for continuous improvement was demonstrated by the staff team within the service. People's dignity and privacy were respected and their independence was promoted.
Since our last inspection a new service manager had been employed by the service.
The service manager was open, committed to making improvements and was in the process of applying to become formally registered with the CQC (Care Quality Commission.) The manager currently registered with us had moved to work in another area of the organisation and was in the process of cancelling their registration.
The service met the characteristics of Requires Improvement overall. More information is in the full report.
Rating at last inspection: Good (report published September 2016)
Why we inspected: This was a planned inspection based on the rating at the last inspection.
Follow up:
As the service is rated as Requires Improvement, we will request an action plan from the registered provider about how they plan to improve the rating to Good. In addition, we will monitor all information received about the service to understand any risks that may arise and to ensure the next planned inspection is scheduled accordingly.
This inspection took place on 21 and 22 July 2016. The service is run from an office in Glossop and provides care to people in North Derbyshire. The provider was given 48 hours' notice because the location provides a domiciliary care service and we wanted to make sure the registered manager was available. In addition we also carried out telephone calls to people using the service on 27 and 28 July 2016.
There was a registered manager at the service. 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.
The service was following the guidance in people’s risk assessments and care plans and the risk of unsafe care was reduced. People’s records were up to date and indicated that care was being provided as detailed in people’s assessments. The records had been updated to reflect changes in people’s care needs. Medicines were managed safely.
People were safeguarded from abuse because the provider had relevant guidance in place and staff were knowledgeable about the reporting procedure. The provider's arrangements for staff recruitment and deployment helped to make sure there were sufficient staff who were fit to work at the service to provide peoples' care.
Staff understood their roles and responsibilities for people's care and safety needs and for reporting any related concerns. The provider's arrangements for staff training and their operational procedures supported this.
The principles and requirements of the Mental Capacity Act (2005) were being met. When required, best interest decisions and capacity assessments had been completed. People were supported by staff who knew them well. Staff were aware of promoting people’s safety, whilst providing information to support people to make day-to-day decisions.
People received appropriate support to manage their meals and nutrition when required. This was done in a way that met with their needs and choices. People’s health needs were met. Referrals to external health professionals were made in a timely manner.
People and their relatives told us the care staff were caring and kind and that their privacy and dignity was maintained when personal care was provided. People and their relatives were involved in the planning of their care and support.
Complaints were well managed. The leadership of the service was praised by external professionals and relatives and communication systems were effective. Systems to monitor the quality of the service Identified issues for improvement. These were resolved in a timely manner and the provider had obtained feedback about the quality of the service from people, their relatives and staff.