Background to this inspection
Updated
17 October 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: This inspection was carried out by one inspector.
Service and service type: This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection. Inspection activity started on 18 September 2019 and ended on 23 September 19. We visited the office location on 18 September 2019.
What we did before the inspection: We sought feedback from partner agencies and professionals. 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 two relatives about their experiences of the care being provided, two members of staff, and the registered manager. We also visited a service user at home to look at the care they received.
We reviewed a range of records. This included two people’s care records and medication records. We looked at one staff file in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection: We continued to seek clarification from the provider to validate the evidence we found.
Updated
17 October 2019
Derwent Court is a domiciliary care service which provides personal care and support to two people aged 65 and over.
People’s experience of using this service and what we found
Staff knew how to raise concerns, but there had been an occurrence where the registered provider had not fully implemented all the recommendations the local authority had made following a safeguarding incident. Systems needed to be put in place to share learning when things had gone wrong. We have made a recommendation about safeguarding.
Risk assessments were in place but needed to be specialised according to the needs of the people receiving care. There were enough staff to deliver care to people, but systems needed to be put in place to monitor the frequency of late or missed care calls.
Staff were experienced in health and social care and had completed various training courses and qualifications with their previous employer. However, the registered manager had yet to implement a robust system to ensure staff were trained and competent in line with current guidelines.
Assessments were carried out but needed to be developed to ensure they were holistic. We have made a recommendation around assessment.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, the systems in the service did not support this practice, because there was lack of evidence the registered provider had provided training for staff.
Staff were compassionate, kind and caring and had developed good relationships with people using the service. People were comfortable in the presence of staff.
Relatives confirmed the staff were caring and looked after people well. People were provided with the care, support, and equipment they needed to stay independent. People had positive relationships with their care workers and were confident about the service.
Policies and procedures were in place to ensure complaints could be dealt with effectively. This was a new service and had not received any formal compliments or complaints.
The service was not delivering end of life care to people, but policies and procedures were available. We have made a recommendation around end of life care.
The registered manager had not considered how differing communication needs could be met. We have made a recommendation about accessible communication.
Systems were in place to seek the views of people who used the service, but they needed to be developed to monitor the quality of service and look at how the service could be continually improved.
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) This service was registered with us on 10 October 2018 and this is the first inspection.
Why we inspected: This was a planned scheduled inspection. We have found evidence the provider needs to make improvement. Please see the safe, effective, responsive, and well led sections of this report.
Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.