Background to this inspection
Updated
26 September 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
Two inspectors and an Expert by Experience undertook this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. They were also the provider. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided. We refer to them as the provider throughout this report.
Notice of inspection
We gave the provider short notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be available to support the inspection. Inspection activity started on 2 August 2019 and ended on 15 August 2019. We visited the office location on 13 August 2019. We had planned to visit the office on 7 August 2019 but postponed our visit by six days to ensure the provider was able to meet with us.
What we did before the inspection
We gathered feedback from seven people and one person’s relative about the service they received via the telephone. We reviewed information we held about the service since the last inspection. We sought feedback from commissioners who work to find appropriate care and support services for people and fund the care provided. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with the provider, a friend of the provider who was supporting them during the inspection visit and the deputy manager. We reviewed six people's care records and medicine administration records (MAR) to ensure they were reflective of their needs. We reviewed records relating to the management of the service including quality audits, training data and people's feedback. We also reviewed two staff files to check staff had been recruited safely.
After the inspection
We spoke with one person and two care workers via the telephone to gather further feedback on the service.
Updated
26 September 2019
About the service
Divine global health Unique Care is a domiciliary care agency providing personal care to people living in their own homes, including, older people, people living with dementia, people with physical and learning disabilities and people with sensory impairments. At the time of our inspection visit 13 people were in receipt of personal care.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People felt safe and had confidence in the ability of care workers to provide effective care. Procedures were in place to protect people from harm. Care workers felt valued and received the support and training they needed to be effective in their roles.
Further improvement was needed to ensure the administration of people’s medicines was consistently safe. The provider took action to address the shortfalls we identified during our visit. Other areas of risk management had improved since our last inspection.
Governance had improved since our last inspection. However, audits and completed checks had not identified the shortfalls we found in relation to medicines.
People were supported to have maximum choice and control of their lives and care workers supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People received care from a small number of consistent care workers. Most people’s care calls had taken place at the scheduled time. However, people told us their care would be improved if care workers always arrived when they expected them.
People spoke highly of the caring nature of their care workers. Care was provided in a dignified way, people felt respected and their independence was promoted. Care workers enjoyed their jobs and knew the people they cared for well. The individuality and diversity of people and the staff team was recognised.
People’s needs had been assessed before they started using the service and people were involved in planning and agreeing to their care. Overall, improvements had been made to care plans since our last inspection which helped care workers to provide personalised care.
People's nutritional needs were met. The service worked in partnership with health and social care professionals to ensure people received effective care. People confirmed care workers followed good infection control practice in their homes.
Systems were in place to manage and respond to complaints. People were happy with the way the service was managed. Feedback gathered from people was used to drive improvement.
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 5 October 2018) and there was breach of the regulations. The provider was asked after the last inspection to complete an action plan to show what they would do and by when to improve. However, they could not evidence they had submitted it. At this inspection we found enough improvements had been made and the provider was no longer in breach of regulations.
Whilst we acknowledge improvements have been made this is the fourth time the service has been rated Requires Improvement.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.