Direct Health Stockton on Tees rated Inadequate by the Care Quality Commission

The Care Quality Commission (CQC) has put Direct Health (Stockton) into special measures to protect their users, after rating them as Inadequate after announced inspection visits in March and April this year.

Direct Health (Stockton on Tees) provides personal care for people in their own homes in Stockton, Billingham, Eaglescliffe and Yarm. It is a large service, providing care to approximately 700 people and employing approximately 200 staff at the time of this inspection.

Under CQC’s new programme of inspections, all adult social care services are being given a rating to help people choose care. We ask five questions, are services; safe, effective, caring, responsive and well led. Overall, Direct Health (Stockton on Tees) has been rated as Inadequate.

The full report from the inspection can be found here on our website: www.cqc.org.uk/location/1-119514236

The report identified a number of areas in which the provider was not meeting the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014:

• People did not receive safe care and treatment due to the registered provider failing to effectively assess and mitigate the risks to service users.
• The registered provider was failing to operate and establish effective systems or processes and to assess, monitor and improve the quality and safety of services provided and mitigate risks relating to the health, safety and welfare of service users.
• The registered provider was failing to ensure that staff receive appropriate training as is necessary to enable them to fulfil the requirements of their role.

When we inspected, we found that medicines were not managed safely; Direct Health (Stockton on Tees) failed to ensure staff obtained information about changes to people's warfarin medication and at times the staff were administering the wrong doses.

We found that staff incorrectly completed mental capacity assessments and failed to accurately determine when someone lacked capacity to make decision. We saw that staff did not complete best interest in line with the requirements of the Mental Capacity Act 2005. Thus they did not involve external healthcare professionals in the decision making process and were making best interest decisions for people who had capacity. For example staff routinely hid people's medication and only shared the storage place via text with each other. Staff told us this occurred for everyone but could not explain why or if people had given permission for this to happen.

We saw the provider’s training chart and a selection of certificates. Their training policy stated that moving and handling, safeguarding and medication training was to be refreshed yearly. Over 30% of staff had not received this refresher training.

We found the service did not have enough staff and there was insufficient capacity to consistently deliver people's care. Many staff had left employment and there were pressures on care workers to work extra hours.

Debbie Westhead, Deputy Chief Inspector of Adult Social Care in the North, said:

“People are entitled to services which provide safe, effective, compassionate and high quality care.

“We found that the care provided at Direct Health (Stockton on Tees) fell long short of what we expect services to provide. Our first instinct is to make sure the service improves, but we must also take action to protect people when we are worried about their safety.”

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service.

Ends

For further information please contact CQC Regional Communications Officer Kerri James by email kerri.james@cqc.org.uk or by phone on 07464 92 9966. Journalists wishing to speak to the press office outside of office hours can find out how to contact the team here. Please note: the press office is unable to advise members of the public on health or social care matters.

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