The Care Quality Commission
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Archived: Zion Domiciliary Care Agency

Overall: Requires improvement read more about inspection ratings

70a High Street, Slough, Berkshire, SL1 1EL

Provided and run by:
Zion Domicillary Care Limited

Important: This service is now registered at a different address - see new profile
Important: This service was previously registered at a different address - see old profile

All Inspections

8 & 9 October 2015

During a routine inspection

Zion Domiciliary Care Agency provides care to adults living in their own homes who have a range of needs including learning disabilities.

The registered manager has been in post since June 2015. 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 and associated Regulations about how the service is run.

People said staff were caring, kind and knew them well. We heard comments such as, “Yes, the (staff) are definitely caring”, “They (staff) care about me as a person. Knowing that they care is important”, “Staff are very kind and ask if I’m okay” and “At the beginning there were some care workers that were not but now they generally seem to be caring.”

We observed a staff member interacting with a person in a respectful way. There was a jovial conversation between them. The person told us they had developed a good connection with the care worker. People said they were involved in the planning of their care however, one person said they did not have a copy of their care plan.

People said they felt safe with Zion Domiciliary Care Agency and knew what to do if they felt unsafe. We heard comments such as, “Generally I am safe and quite secure.” Staff attended relevant training and knew how to protect people from abuse. Most people felt there were enough staff. This was because they always had the required number of care staff to attend to their care needs. A review of staff rotas showed there was adequate staff covering shifts.

People gave mixed comments in regards to staff being knowledgeable and skilled to do their jobs. Whilst most people thought staff were experienced and skilled, other people mentioned issues with care workers not understanding the English language. Staff received appropriate induction, training and supervision.

Spot checks were carried out to ensure staff followed the service’s procedures. Where areas of concern were identified, appropriate action was taken.

People’s care needs and risk assessments were not regularly reviewed. One person commented, “Since I was released from hospital they (staff) haven’t visited to review my care.”

Care records reviewed contained no information in regards to people’s preferences or wishes in regards to end of life care. People said the service had not discussed end of life care with them.

We have made a recommendation about the service seeking people’s preferences in relation to end of life care, base upon best practice.

People were supported to have sufficient food to eat and drink. Care records contained people’s nutritional needs; what their food preferences were and what support they required. The service worked with other health professionals to ensure people’s health needs were met.

Staff were aware of the implication for their care practice in regards to the Mental Capacity Act 2005 (MCA). Where people were not able to make specific decisions, care records showed who had legal powers to make important decisions on their behalf. We noted the service did not carry out its own mental capacity assessments. This meant mental capacity assessments undertaken were not time and decision specific. We have made a recommendation for the service to seek guidance on undertaking mental capacity assessments based upon the MCA.

People said they knew how to make a complaint and felt comfortable to do this. Staff knew how to handle complaints and confidently spoke about the procedures they would follow. This was in line with the service’s complaints policy.

People gave positive feedback in regards to how well the service was managed but also spoke about where there could be further improvements. For instance, training for staff where English was not their first language and communication in regards to what was happening in the service.

Quality assurances systems in place to monitor and improve the quality and safety of the services provided was not being used effectively. There was no evidence of analysis and communication to let people and staff know the results of the surveys and any actions the service was going to take. Audits of care plans failed to pick up one person did not have a copy of their care plan and formal reviews of people’s care were not regularly being undertaken.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

6 February 2014

During an inspection looking at part of the service

People told us they were happy with the care received. We heard comments such as, 'I am happy with the service, it meets our needs', 'I am very pleased', 'Generally satisfied', and 'They're much better than my last care company, more approachable and 'We could not cope without them.'

We found all care needs assessments, support plans and risk assessments were fully completed and regularly reviewed. This meant people's care needs were assessed and care delivered ensured people's welfare and safety.

We looked at all documents provided by staff in regards to their recruitment and saw no staff had exceeded hours specified in work visas. This showed the service carried out effective checks when recruitment was undertaken.

One staff member commented, 'I am receiving supervisions more often' and another staff member told us, 'I always get the help when I need it. They are very supportive.' Records showed supervisions were undertaken regularly. These showed supervisory arrangements were in place to ensure staff were supported and managed at all times.

We reviewed the quality audit' document and saw it was newly developed and was in the process of being used. It outlined audits undertaken for medication administration; support plans; complaints, service user surveys and safeguard people. This enabled the service to identify areas of where there was a risk of non-compliance and put in place actions to address them.

14 June 2013

During an inspection in response to concerns

We spoke to three people, they told us their current care workers were reliable and staff generally came on time. In two of the care plans viewed we found needs assessments were not fully completed. This showed people who used the service could not be confident the service provided safe and appropriate care, treatment and support to meet their needs.

The manager spoke with us about a member of staff who was working 20 hours a week. We informed them that the staff's passport indicated they were on a student visa and only entitled to work 10 per week. The manager said they were not aware of this. This showed the service did not have effective recruitment procedure and processes in place to ensure staff members entitled to work in the UK did not exceed the hours specified on their visas.

One staff member told us: 'The training was adequate.' We found there was no evidence of training for one member of staff who worked with people. This showed people who used the service could not be confident they were treated by staff members who were appropriately trained to provide care, treatment and support.

We saw no audits of care plans, staff supervisions and appraisals undertaken to analyse and use information gathered to identify non-compliance, or any risk of non-compliance. This showed there were not appropriate systems for gathering, recording and evaluating accurate information about the quality of care, treatment and support the service provided.

6 September 2012

During an inspection looking at part of the service

We did not speak to people for this inspection. However, we looked at the agency's weekly monitoring feedback forms from telephone calls which were made to people who used the service. We found when people had commented on their care those comments had been used to make improvements to their care. We saw evidence that regular monitoring of the quality of the care was taking place.

We looked at personnel records for five staff who were recently recruited. We found that the agency had reviewed its recruitment process to make sure it was effective. Where concerns had been raised by people about their care those had been investigated. People were informed of the outcome of the investigation in writing.

18 June 2012

During an inspection in response to concerns

The five people whom we spoke with said that they were happy with the care they were receiving from the agency staff. They described staff as 'respectful, polite and very good.' A relative of a person who used the service said 'I am happy with the care and the staff member who visits us. We are able to communicate with her because she speaks our language.'

People told us they were visited by the manager before the agency started to provide them with a service. They said the level of support to be provided was agreed and discussed with them.

People said that they had a care plan which staff followed. A person who used the service said 'everything is done exactly the way I like it.' A second person said 'staff respect my privacy. They always knock on the bedroom door before entering.' A third person said 'staff prepare my meals and always ask how I like it.'

People told us that staff were usually punctual. However, if they were running late someone from the office would make them aware. A person who used the service said that someone from the office usually visited them to check that staff were doing their job.

We spoke to two stakeholders who commissioned the care package on behalf of people who used the agency. They told us that the agency was providing a service to people with quite high needs. They described the agency as 'very accommodating and keen to work with them.' They said when concerns had been raised the agency had acted appropriately to address them.

People using the service whom we spoke with said they felt safe and comfortable with staff entering their homes to provide them with support. They told us that staff spoke to them in a calm and respectful manner.

People said that they received a telephone call from the agency on a weekly basis. This was to seek their views on the service they were receiving.