Archived: GreenSquareAccord Doncaster

Direct Health – Doncaster is a domiciliary care agency providing support for people in their own homes. At the time of our inspection there were 178 people using the service.

People’s experience of using this service:

The registered manager had worked with the provider in addressing the shortfalls identified at the last inspection and to make further improvements in the service. For instance, improvements had been made in the effectiveness of the quality and safety audits.

People felt safe and happy with the staff who cared for them. For instance, one person said, “They are marvellous, really lovely. I would say they are first class.” Staff received daily messages via text and e-mail to make sure they had access to up to date government guidance on Covid-19 infection control. Risks were well managed, and people’s medicines were managed safely. Staff had a good understanding of how to safeguard people from abuse and there were enough staff to meet people’s needs and keep them safe.

People had regular contact with the care coordinators or members of the management team and most praised the care staff and the care coordinators very highly. People were asked for feedback about the care provided and the provider used this to improve the service. It was also evident the team worked well in partnership with other professionals to provide a person centred service that met people’s needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update:

The last rating for this service was good, with requires improvement in the key question of well led. (published March 2018). At this inspection we found improvements had been made.

Why we inspected

We were made aware of concerns in relation to how some people’s care had been provided and managed. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

The concerns we received related to infection control, staff changes and the induction of new staff, medication and the management culture. We used this information when both planning and carrying out our inspection.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not include them in this inspection. Ratings from the previous comprehensive inspection for those key questions were used in calculating the overall rating at this inspection and the overall rating for the service remains good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Direct Health (Doncaster) provides personal care to people living in their own homes in the Doncaster area. At the time of our inspection there were 90 people using the service.

We carried out the inspection a little earlier than planned due to concerns raised with us about the way the service was operating. However, we found improvements had been made since the concerns were raised and the majority of people were very happy with the service provided.

At the time of our inspection the service had a registered manager in post. 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.

The service have had some operational issues within the last six months, which were related to a number of management and care staff leaving in a particular geographical area. This had a negative impact on the continuity and quality of care provided to some people who used the service in that area. However, there was evidence to suggest that since the new registered manager was appointed, improvements had been made resulting in significant progress being made in resolving the issues arising. The registered manager was experienced, competent and proactive. We saw that they were aware of every individual concern and continued to take positive and effective action to address them.

The service had also experienced a small number of occasions in the previous six months when scheduled calls had been missed. This was an issue that the registered manager had effectively addressed.

The majority of people praised the service and spoke very highly of the care and support provided by the staff. A small number of people and their relatives expressed concerns about the reliability of the service. When people had regular care workers they received consistent levels of care by staff who knew them. However, people told us issues had arisen when their regular care worker was not available and less experienced staff, who they did not always know, were allocated to provide their care. Some people told us that they felt the service had a high turnover of staff. These were issues that the registered manager was addressing and had made significant improvements in.

The service had arrangements in place for recruiting staff, and pre-employment checks were carried out prior to staff commencing work.

The registered manager had undertaken work to ensure people received their medicines safely and to ensure are plans included clear information about risks associated with people’s care and how to minimise the risks without unduly restricting people’s freedom.

The service had a policy in place for safeguarding people from abuse and neglect. Staff had received training in this area and knew what to do if they suspected abuse.

Overall, people were supported to have their assessed needs, preferences and choices met by staff who had the necessary skills and knowledge. If there were issues with any staff member’s competence or commitment, this was addressed in a fair and effective way.

People’s care plans identified the support they required during mealtimes, to ensure they were supported to eat and drink sufficiently to maintain a balanced diet.

People were supported to maintain good health, have access to healthcare services and received ongoing healthcare support.

People who used the service were aware they had a care plan and had been involved in reviews to ensure the plan was up to date. People’s relatives had also been involved, where appropriate. This helped to make sure the plans were personalised and detailed enough. All of the staff we spoke with had a very good understanding of the individual needs of the people they were caring for and of how each person chose to have their care delivered.

The service had a complaints system in place. Some people and their relatives told us they had raised concerns and had not been satisfied with the response. However, the registered manager had worked very hard to resolve these complaints and was making good progress.

We saw various audits had taken place to make sure policies and procedures were being followed and it was clear what had been done to address any shortfalls. People were consulted about their satisfaction in how the service operated and their opinions taken into account. The registered manager ensured any areas for improvement were acted upon. However, some people remained unhappy with the continuity and reliability of the service.

Staff we spoke with felt the service was well led and the new registered manager was approachable and listened to them.

Further information is in the detailed findings below.