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Archived: Derbyshire care Services Central and West Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 9 August 2017

This inspection took place on 20 and 22 June 2017 and was announced. The provider was given 48 hours' notice. This meant the provider and staff knew we would be visiting the service’s office before we arrived. This was the first inspection since the provider's registration on 10 October 2016.

Derbyshire care Services Central and West is a domiciliary care agency providing personal care to older people and younger adults in their own homes across the central and west areas of Derby including Littleover, Mickleover and Allestree. This included people with physical disabilities and mental health. The agency is located close to Derby city centre. At the time of our inspection 182 people received the regulated activity of personal care.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission. 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.

We found that the provider's quality assurance systems had not picked up the issues we identified at this inspection visit. This demonstrated that the management systems were not always effective in recognising areas which required improvements.

The provider's arrangements for staff recruitment were unsafe and did not ensure suitable people were employed. We found that all the required pre-employment checks were not in place.

The Mental Capacity Act (MCA) 2005 helps to ensure that people are supported to make their own decisions wherever possible. Where people were identified as not having capacity there were no records of best interest decision making to show the care and support provided was in the person’s best interests. Care staff's knowledge on the MCA varied and not all care staff had been trained in this area. Training records also showed that care staff had not received training in all areas as identified by the provider.

People were not consistently involved in reviewing what support they needed. People told us they appreciated regular care staff; where people did not receive regular care staff they felt their care was compromised in a variety of ways.

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, care staff confirmed if they were concerned about people’s health care needs they would notify the office or contact the relevant service as required.

People told us care staff treated them in a caring way and respected their privacy. Care staff supported people to maintain their dignity. The delivery of care was tailored to meet people’s individual needs and preferences.

Care staff told us they felt supported by the management team and told us they received regular supervision.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Requires improvement

Updated 9 August 2017

The service was not consistently safe.

Recruitment procedures did not ensure suitable staff were employed as not all recruitment checks were in place. The provider did not have effective systems in place to reduce the risk of abuse and preventable harm to people using the service. Risk assessments were not always in place to ensure staff could minimise risks to people and to support them safely. Sufficient staff were available to attend calls, although people were not always advised if their call was delayed. People had the support they needed to take their medicines as prescribed.

Effective

Requires improvement

Updated 9 August 2017

The service was not consistently effective.

Mental capacity assessments had not been completed to identify the support people needed to make decisions. Not all staff had been trained in the areas identified as relevant to people’s needs. People were supported to maintain their nutrition, health and well-being where required.

Caring

Good

Updated 9 August 2017

The service was caring.

People were cared for by staff that were caring and friendly. People and their relatives were involved in their care and staff respected people's wishes.

Responsive

Requires improvement

Updated 9 August 2017

The service was not consistently responsive.

People received personalised care, responsive to their needs. However people were not consistently involved in reviewing what support they needed. People were not always supported by regular care staff to ensure continuity of care. The views of people and their preferences were respected. People knew how to make a complaint or suggestion.

Well-led

Requires improvement

Updated 9 August 2017

The service was not consistently well-led.

The service had a registered manager in post. Systems designed to check on the quality and safety of the service people received were not effective. For example people did not always experience improvements when they have shared their views. Statutory notifications had not always been submitted as required. Care staff told us they enjoyed working for the provider and felt supported by the management team.