Destiny Nursing & Care Agency Ltd

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement: This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The registered manager had a process for incident reporting. There was a form for staff to complete and a template for them to be recorded on. This included the date, those involved, details of the investigation, any action taken and lessons learnt. At the time of our assessment, no incidents had been reported.

Staff confirmed information was shared with them. A staff member said, “They are very good with sharing information through all the forms that information can reach staff for a quick action to be taken.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The registered manager told us a person had recently moved from their service to a care home, and they had worked closely with their social worker to support this.

The registered manager had a process to manage safeguarding concerns. They told us staff were expected to report any concerns to the office, and they would investigate them. They were aware these needed to be reported to the local authority and CQC. We noted the safeguarding policy did not include contact details for all local authorities where people received care. This meant staff may not have the details needed to share with the appropriate team. Following our assessment, the registered manager told us the safeguarding policy was being updated, and contact details were available for staff in service user files and displayed in the office.

Staff we spoke with said they would report any concerns to their manager. Another staff member told us, “We also have clear safeguarding procedures in place, and I feel confident using them if I needed to.”

People’s relatives confirmed they felt their families were well looked after and safe and at the time of our assessment, no safeguarding concerns had been raised.

The registered manager had assessed risks to people and records included guidance for staff in how to manage these. They were detailed; however, we found some slight discrepancies such as a person’s nutrition risk assessment stated they were diabetic, but this was not mentioned elsewhere in their care record. It also stated they were nil by mouth whereas the care plan stated they could have soft food in small portions and limited fluid with supervision. We fed this back to the registered manager who told us they would review the record to make it clear.

People’s relatives confirmed they felt people were safe and well cared for by staff who were familiar with their needs.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Staff assessed people’s homes for risks in relation to the environment. We saw this included information about utilities, lighting and trip hazards. People’s relatives said staff told them when equipment such as hoists needed to be serviced.

People’s personal data was kept securely. There were lockable cupboards in the office where paper records were stored.

The registered manager’s staff training matrix did not include courses in all conditions people had and showed not all staff had completed the mandatory training. For example, no staff had completed training in learning disability and autism or dying, death and bereavement and only 4 out of 12 staff had completed training in safeguarding and medicines administration; these were completed in 2021. We fed this back to managers who advised learning disability training had been booked and sent a revised training matrix which showed all staff had completed safeguarding training in 2024 and moving and handling in 2025. The other gaps remained. Some courses were not on the matrix for other needs people had, including for complex needs such as suctioning and preparing food to special textures. Following our assessment, the registered manager told us staff were trained, and the matrix had since been updated to reflect this, but we did not see evidence of this. They also told us staff were not trained in suctioning, and no one were supported with this. This conflicted with feedback we received during our assessment. People had not experienced risk; relatives we spoke with were very happy with the care provided and confirmed there had never been any incidents.

People received consistent support from a small team of staff who knew them well. People’s relatives confirmed staff arrived on time and if there was a change in staff they tended to be informed, and it was staff who they knew. A manager said, “We always have additional staff as do not have many service users. Especially with live-in, we have relief carers, so they know the client.”

The provider assessed and managed the risk of infection. They had an infection prevention and control (IPC) policy. People’s relatives confirmed staff washed their hands and wore personal protective equipment (PPE) as appropriate. A relative said, “They have gloves. They have a plastic apron.”

The registered manager had not ensured staff were competent in administering medicines. The training matrix showed 4 out of 12 staff had been trained in administering medicines. This was completed in 2021; we would expect this to be refreshed. We requested staff competency assessments in administering medicines and those provided were dated the day of the inspection or just after. This meant we were not assured they were done prior to our request. However, we did not find any issues with meds records reviewed and people’s relatives were happy with how medicines were managed. They told us staff let them know when they needed to contact the pharmacy to order more.