Archived: Direct Health (Rotherham)

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures were in place and staff understood how to safeguard people they supported. All staff had received safeguarding of vulnerable adults training.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them, and information was available that told staff how to support them. Relative we spoke with told us they were happy with the care and support given by staff at the agency. People we spoke with told us the care staff were very good. One relative told us, 'I don't know how we would cope without our regular carer, they are fantastic.'

Is the service caring?

Care and treatment was planned and delivered in a way that ensured people's safety and welfare. Relatives we spoke with told us there was a care plan which staff recorded the details of the care and support given at each visit. We found records held at the office reflected the care delivered to the people we visited.

One relative we spoke with said, 'The staff are very good and are very respectful.'

We visited people with a care worker and observed the care workers interacted positively with people who used the service. Staff showed patience and gave encouragement when supporting people.

Is the service responsive?

People knew how to make a complaint if they were unhappy. Relatives told us they had raised concerns in the past and they were listened to and the manager resolved the issues.

The service was short staffed at our visit and the care co-ordinators had to cover a large amount of care hours in addition to their roles as care coordinators. The service was split into three teams and one team did not have a care co-ordinator. The provider was not taking any action to resolve this and it was starting to impact on staff. We spoke with the provider after our visit and they assured us the issues were being dealt with and confirmed this in writing to us.

Staff told us they had not had team meeting since November 2013 and did not know who to contact if any problems arose as they were aware the manager and other coordinators were very busy. This could potentially impact on the care delivery if not resolved.

Is the service well-led?

The manager had covered a large number of care hours in the last two weeks. They had worked over 20 hours each week delivering care to cover staff shortages and sickness.

Staff told us they were clear about their roles and responsibilities. This helped to ensure that people received a good quality service at all times. Although they said at times there was lack of communication and many calls were changed at last minute. They felt there was no organisation of calls and this meant they did a lot of mileage between 15 minute calls. They said this wasted time when there were a number of calls in one area, but were not grouped together with one carer.

People told us their care staff were lovely understood their needs and how to care for them. People also told us that whether it was their usual care staff or a new staff member covering they were treated with respect, listened to and given choices. One person told us. 'The staff that support me are brilliant, I can talk to them and have a laugh and a joke.'

People who used the service were not always protected from the risk of abuse, because the provider had not followed proper safeguarding procedures. The provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We found that there wasnt an effective recruitment and selection processes in place. The provider had a policy and procedure however we found this was not being followed. This meant people who were not suitable to work with vulnerable people could be employed.

We were told there was an effective system to regularly assess and monitor the quality of service that people received. However we found this was not being followed. This could put people at risk of potential harm.

Relatives we spoke with told us the manager was very good, they said they were approachable, listened to them and resolved any issues they raised.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

There was an effective system to regularly assess and monitor the quality of service that people received. There was also a complaints policy that took account of complaints and comments to improve the service. People we spoke with told us if they raised any issues with staff they were always dealt with.

People's records were accurate and fit for purpose. We looked at four plans of care these contained an assessment of needs and appropriate information and documentation in relation to the person's care. People we spoke with told us they were involved in implementing their plan of care. We also saw they were regularly reviewed.

We found care plans lacked detail and care staff told us that if they were visiting a new person it was sometimes difficult to ascertain their needs due to care needs not being properly documented in the plans of care.

You can see our judgements on the front page of this report.