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Archived: Direct Health (Coventry)


Inspection carried out on 14 January 2013

During a routine inspection

We spoke with four people who used the service. They told us they were pleased with the service being provided by Direct Health (Coventry). They told us staff were well trained and understood their care needs. Typical comments given to us were, �The lady who comes in is absolutely marvellous�, �They treat x with dignity and respect�, �My regular carers are really good�they have it (care) down to a fine art.�

We spoke with four staff care staff and three office staff. Care staff told us they had received good training to support them in providing care to people using the service.

We looked at the care records of three people using the service. We were satisfied they provided staff with the information they needed to understand the care requirements of people and to ensure care was delivered safely.

We checked the medicines policy of the service and how this was put into practice. We were satisfied staff had a good understanding of the policy, and administered medicines safely.

We looked at the way the service managed complaints. The service had received one formal complaint during 2012. We were satisfied this had been investigated appropriately. The service also had good systems in place to identify and act on any informal concerns raised.

We looked at recruitment practice. The service undertook relevant checks to ensure staff were safe to work with people using the service.

Inspection carried out on 11 September 2012

During a routine inspection

We visited the agency office on the 6th September and looked at five care files and spoke to three care workers as well as the branch manager and area manager. We selected three tenants with different needs to pathway track. Pathway tracking enables us to look in detail at a persons care and support and to find out their experiences of using the service. The files we sampled all contained care plans and needs assessments completed by the agency. Assessments and support plans were being reviewed regularly and updated if needed.

We spoke to six people who used the service. People we spoke to said they were involved in their care and had given their consent for the agency to provide the support required. Care staff we spoke with demonstrated a good understanding of client needs and gave examples of promoting independence and maintaining peoples� privacy and dignity. One member of staff told us, �We encourage x to do as much for himself as possible�. People we spoke to said they are encouraged and supported to do things for themselves. One person told us "I am able to do most things for myself but the carer does what I no longer can�.

Plans we looked at provided staff with good information about the care support required and people said they had copies of care plans in their homes. People we spoke to said carers stayed long enough to do everything they needed, three people said staff take their time and don�t seem to rush. The times of calls were not recorded on the plans we sampled and not all the people we spoke to knew what time their carers were supposed to arrive. Four people said that carers usually arrived within a half an hour time slot but two people said carers could arrive anytime between 8.30am and 10am which they said was a long time to wait. People said they are beginning to get consistent carers, but until very recently this was not happening, carers also said this was improving. The manager told us since he has been at the agency he has visited several clients, at their request, to discuss concerns over call times and said issues raised were being easily resolved. People we spoke to were happy with their carers�, one person said �I am happy with the service I get, the girls I have do everything I need�. The relative of another client said, �I�m sometimes with dad when the carer arrives, they know him quite well now and he looks forward to seeing them�.

Four people we case tracked needed assistance with moving and handling. People we spoke to said care staff were competent doing this and knew what to do. Records showed that risk assessments for pressure area care had been completed but the care plans we looked at did not contain any pressure area management and this needs improving. One person who was looked after in bed had bedrails fitted. There was no risk assessment for the use of bedrails and no details in the care plan about how these should be used safely. The managers gave their assurance this would be quickly rectified.

People who use the service continue to manage their own medication if they can do this safely, if not staff will assist people to take their medication as prescribed. The procedure for assisting people with medication is safe but the process for auditing medication records needs improving. The manager agreed to revise the auditing process to clearly show that medication records have been looked at and audited.

People who use the service are supported by care staff that have been properly recruited and have completed the required training to work with people safely.

All new staff completes a structured induction process and shadow an experienced worker before working on their own. The agency has a procedure for supervising and supporting staff however staff we spoke to said they had not had supervision for a long while. We were told the supervision process for existing staff was over due as the agency had been concentrating on supporting new staff through inductions. The manager agreed to address this.

The agency had procedures in place for monitoring the service they provide. People we spoke to said they were asked for their views and opinions of the service and had information about making complaints.