Archived: Divine Global Health Unique Care

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.

Divine Global Health Unique Care is registered to provide personal care support to people. At the time of our inspection the agency provided personal care support for 12 people and employed nine care workers, including two seniors and a care co-ordinator. The service is located in Coventry in the West Midlands.

This service is a domiciliary care agency. It provides personal care to people living in their own homes, including, older people, people living with dementia, physical and learning disabilities and sensory impairment.

We last inspected Divine Global Health Unique Care in October 2017 and gave the service an overall rating of 'Requires Improvement'. This was because the provider’s quality monitoring systems were not always effective and some records relating to the management of medicines and risks associated with people’s planned care did not assure us these were being consistently and safely managed.

At this inspection on 7 August 2018 we checked to see if improvements had been made and if they were effective. We found some areas continued to require improvement and other areas where standards previously demonstrated compliance with regulations had not been maintained.

This is the third consecutive time the service has been rated as requires improvement.

The service had a registered manager. A requirement of the provider’s registration is that they have a registered manager. 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 registered manager is also the provider for this service and is referred to as the provider throughout this report.

The provider had not ensured people’s medicines were consistently managed and administered safely, and in line with their procedure. Records to support the management of risk associated with people’s planned care required improvement. Despite omissions in records care workers understood the risks associated with people’s care and how these should be managed.

The provider's checks and audits to monitor the quality and safety of the service people received were not always effective. Feedback from people and relatives was not used in a timely way to make improvements to the service.

People felt safe with their care workers and there were enough care workers to provide all planned care calls, for the length of time needed. Systems and process were in place to safeguard people from harm. However, these were not consistently followed by care workers and the provider in line with their regulatory responsibilities.

Care workers received an induction into the organisation, and a programme of on-going training to support them in meeting people's needs effectively. However, we could not be sure all training was delivered by a suitably qualified person. The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people in their homes. Care workers had their practice regularly checked by the provider.

People were concerned about the inconsistent times of their care calls. People received their care calls from care workers they knew and for the length of time agreed. However, There were enough care workers to provide all planned care visits to meet people’s needs effectively. Care workers respected people’s privacy and dignity and encouraged people to be independent where possible

The provider understood their responsibility to comply with the relevant requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Care records contained information about the support people needed to make decisions. Care workers gained people’s consent before they provided personal care and respected people’s decisions.

Some care records were personalised and informed care workers how people wanted their care and support to be provided. People and, where appropriate, relatives were involved in developing and reviewing planned care. Care workers had a good understanding of the needs and preferences of the people they supported.

People and relatives had mixed views about the attitude of their care workers and the effectiveness of care workers knowledge and skills to meet their needs. People who required support had enough to eat and drink and were assisted to manage their health care needs.

People and relatives felt the provider was approachable. Care workers felt valued and received regular management support through individual and team meetings. People knew how to complain. Complaints that had been made were not always managed in line with the provider’s policy and procedures.

We found one breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Some care records were personalised and informed care workers how people wanted their care and support to be provided. People and, where appropriate, relatives were involved in developing and reviewing planned care. Care workers had a good understanding of the needs and preferences of the people they supported.

People and relatives had mixed views about the attitude of their care workers and the effectiveness of care workers knowledge and skills to meet their needs. People who required support had enough to eat and drink and were assisted to manage their health care needs.

People and relatives felt the provider was approachable. Care workers felt valued and received regular management support through individual and team meetings. People knew how to complain. Complaints that had been made were not always managed in line with the provider’s policy and procedures.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The service was last inspected on 14 February 2017. At that inspection we found four breaches in the legal requirements and Regulations associated with the Health and Social Care Act 2008. (Regulated Activities) Regulations 2014.

These breaches were in relation to the care and support people received. The provider did not ensure people were supported by staff who were of suitable character and had received the induction and training needed to support people safely and effectively. Known risk associated with people’s planned care had not been assessed. Risk assessments that had been completed did not clearly inform staff how to minimise risk to keep people and themselves safe. Information was not available to show people’s medicines were administered safely, by care workers who remained competent to do so. The provider did not have effective systems and process to make sure they checked the quality and safety of the service people received.

We gave the home an overall rating of requires improvement and asked the provider to send us a report, to tell us how improvements were going to be made to the service. The provider sent us an action plan which detailed the actions they were taking to improve the service. The provider told us these actions would be completed by June 2017.

At this inspection on 6 October 2017 we checked to see if the actions identified by the provider had been taken and if they were effective. We found sufficient action had been taken in response to the breaches in Regulations of the Health and Social Care Act 2008. However, there were still some areas where improvements were needed.

The service had a registered manager. A requirement of the provider’s registration is that they have a registered manager. 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 registered manager is also the provider for this service and is referred to as the provider throughout this report.

The provider conducted pre-employment checks prior to staff starting work, to ensure their suitability to support people in their homes. Care workers received a comprehensive induction when they began working at the service and had their practice regularly checked by the provider.

The provider completed checks and audits to monitor the quality and safety of the service people received. However, these were not always effective and required further improvement.

Care records included information about people’s backgrounds, preferences and needs. Most care records provided staff with the detail they needed to provide personalised care and build relationships with people. Care workers had a good understanding of the needs and preferences of the people they supported.

People and relatives told us they felt safe using the service. Risks to people’s safety were assessed. However, some risk assessments lacked the detail care workers needed to ensure they kept people and themselves safe. Action was being taken to address this. Despite omissions in records care workers understood the risks associated with people’s care and how these should be managed.

The provider had developed systems to gather feedback from people so they could use the information to improve the quality of the service provided. People saw health professionals when needed and support was given to people who required help with eating and drinking. Systems were in place to manage people’s medicines and care workers had received training to do this. However, care workers did not always complete medicine records accurately.

People received their care visits from care workers they knew. Care calls were consistently made at the time arranged, and care workers stayed for the length of the time agreed. There were enough care workers to provide all planned care visits to meet people’s needs effectively. Care workers respected people’s privacy and dignity and encouraged people to be independent where possible.

The provider understood their responsibility to comply with the relevant requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Care records did not always contain information about the support people needed to make decisions. Care workers gained people’s consent before they provided personal care and respected people’s decisions. Staff had been trained to understand how to protect people from abuse.

People and relatives told us their care workers were caring and respectful and had the right skills and knowledge to provide the care and support required. Care workers completed on-going training the provider considered essential to meet people’s needs safely and effectively.

People and relatives were involved in planning their care and knew how to make a complaint if they needed.

People and relatives were satisfied with the service provided which they felt was well managed. Care worker felt supported by the provider who was accessible and approachable.