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Discovery Home Requires improvement

Reports


Inspection carried out on 3 September 2019

During a routine inspection

About the service

Discovery Home is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to children and younger disabled adults. 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.

At the time of the inspection the provider was supporting 79 people in the London Boroughs of Tower Hamlets and Newham, however only 17 people were receiving personal care. The remaining people were supported with befriending and outreach support.

People’s experience of using this service and what we found

Although there were monitoring processes in place, there was not an effective system in place to ensure accurate records about the care and support people received were being completed or audited to ensure their needs were being met.

Minor improvements were needed to ensure safer recruitment processes were followed and evidence of satisfactory conduct in previous employment within the health and social care industry had been obtained.

Relatives were positive about the kind and compassionate attitude of the staff team. One relative said, “I am very happy and would definitely recommend them.”

Relatives told us how important it was that staff could communicate with them and their family members in their own language and understood their cultural requirements.

Relatives were reassured with the skills and experience of their regular care workers when managing complex health conditions and behaviours that challenged the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Relatives spoke positively about the management of the service and felt any issues would be dealt with appropriately by the registered manager. Relatives told us they felt comfortable approaching the management team if they had any concerns.

People were supported by a staff team that felt motivated working for the provider and praised the support they received.

We have made two recommendations that the provider ensures guidelines for staff to follow to minimise assessed risks are updated in people’s care records and safer recruitment processes are followed.

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

Rating at last inspection

The last rating for this service was Good (published 5 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified one breach in relation to good governance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality. 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.

Inspection carried out on 27 January 2017

During a routine inspection

We carried out an announced inspection on Discovery Home on 27 January 2017. We gave the provider 48 hours’ notice to ensure the key people we needed to speak with were available. Our last inspection took place on 30 November 2015 where we found breaches of the regulations in relation to consent and good governance. The provider submitted an action plan telling us how they were going to make improvements to the service and during this inspection we found that this action had been completed.

Discovery Home provides care and support for adults and children with complex needs in their own homes. The domiciliary care service operates from the provider’s eight bedded respite service for children which helps family carers take a break from caring responsibilities. At the time of this inspection the domiciliary care service was providing support to six adults and nine children.

The service did not have a registered manager in post. At the time of our inspection a candidate and been recruited to the registered managers position but had not yet started their role. 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.

Recruitment checks were carried out to assess the suitability of the staff employed by the service. There were enough staff available to meet people’s needs. Staff received an induction and regular training which ensured they had the required skills to meet people’s needs.

People were involved in planning their care and consented to their plans of care. Risks had been assessed, and reviewed when people’s needs had changed and action was taken to safeguard people from abuse. Continuity of care was available to people who used the service as they were given to the opportunity to access additional services offered by the provider.

The principles of the Mental Capacity Act 2005 (MCA) were followed. Staff had completed training and understood the MCA, and people’s consent was sought in line with legislation and guidance.

People’s health and nutritional needs were met and any concerns acted upon. People told us staff treated them in a caring and kind way and respected their dignity. Staff listened to people’s wishes and supported them to make choices about their care. People’s relatives told us they were supported by caring staff.

The provider considered people’s individual needs and made changes which ensured they received their care in a way they preferred. People told us they knew how to complain and the provider had a system in place to record and respond to complaints.

The provider promoted an inclusive culture. People felt the management were approachable and that they were supported. People were encouraged to share their experiences and these were acted on to improve the quality of care provided. Systems were in place to monitor the quality of the service provided to ensure the service was effectively delivering good quality care.

Inspection carried out on 30 November 2015

During a routine inspection

The inspection took place on 30 November 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. The service was last inspected on 22 October 2013. It was found compliant in all areas we looked at.

The service is registered to provide support to adults and children living in their own homes with personal care. At the time of our inspection 16 people were using the service.

The service had a registered manager in place. 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.

People who used the service and their relatives had positive experiences of the care and service they received. Relatives we spoke with said they were very happy with the service their family members received and the staff who delivered care.

People were protected by procedures in place to safeguard them. Staff had knowledge and training about how to identify abuse and keep people safe. Risks to people in relation to their care and welfare were assessed and managed. Staff were sufficient in numbers and skill mix to safely meet people’s needs. Staffing levels were assessed and staff allocated to ensure the safety of the service based on individual needs. All staff were vetted prior to commencing work. Criminal record checks were completed for all staff and essential recruitment documents and records were in place.

People were supported to maintain good health and had access to ongoing healthcare support. The provider kept records of regular contact with health and social care professionals.

Whilst staff were aware of the need for people to consent to their care and support, the provider’s practice was not in keeping with the requirements of the Mental Capacity Act 2005 and staff lacked training and experience in this area to ensure that people’s rights were protected.

Staff received an induction when they began work and mandatory training to ensure they had the knowledge and skills they needed to meet people’s needs. Staff were supported through regular meetings with their manager.

People who used the service were treated with dignity and respect. Relatives of people who used the service told us that staff were kind and caring and considerate in the way they provided care.

Care was planned and people and their relatives spoke highly about the service and how their care was delivered. Whilst support plans were personalised to some degree, some support plans were not sufficiently detailed and needed further development. Staff understood people’s needs in relation to their culture, language and diverse needs.

Issues of concern were addressed but were not always recorded to ensure the service dealt with the issues appropriately, and to ensure the service was continually responsive to meeting people’s needs.

Staff spoke well of the management and said they were available whenever they needed them and that they received good training and support. The provider had systems in place to monitor the quality of service. However these systems were not always effective in identifying and addressing shortfalls and ensuring that feedback was used to assess, analyse and improve the quality of the service.

We found breaches of regulations relating to consent and good governance. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 22 October 2013

During a routine inspection

At the time of this inspection the agency had been running for almost three months. They were providing personal care to one young person who used another of The Qalb Short Break Services for respite care. The person using the service was unable to communicate with us over the telephone and we therefore spoke with their relative. Their relative made positive remarks about the quality of the care and support provided by Discovery Home. They said, "we are very happy with the service they know my relative well as they supported them at the respite centre for over two years. They can support my relative in the way they need."

We were told that the family were involved in the person�s care planning. We saw that the person's care needs were assessed and recorded in their care plan. Risk assessments had been carried out. Systems were in place to protect people from abuse and the relative of the person using the service said they felt safe.

We spoke with three members of staff, including the manager, about the training and support provided by Discovery Homes. They told us they received regular training, supervision and an annual appraisal.

As the agency was new the manager told us it was too soon to ask people and staff to give feedback about the quality of the service through a survey. However the relative we spoke with told us that the manager visited them every two weeks to check whether they were happy with the service provided.