20 June 2017
During a routine inspection
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.