Destiney Social Care Provider

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

While people we spoke to said that they were generally happy with their care, our assessment found elements of care did not meet the expected standard. We identified a breach of the legal regulations. At the last inspection, some of the provider's governance systems required improvement to ensure people continued to receive good quality and safe care. At this inspection, we found the provider's governance and quality assurance systems needed further improvement. Management and staff did not always follow the regulations, best practice guidance, or their own policies and procedures. The provider had systems in place to safeguard people from the risk of abuse, including the training of staff in how to recognise and report abuse. However, these did not effectively ensure people were protected from the risk of avoidable harm because they were not operated effectively.The provider acknowledged the service had received concerns from the local authority, relatives, and staff. Throughout the inspection, the registered manager was honest and open with us. They acknowledged the shortfalls at the service and were eager to put processes in place to ensure people receiving care and support were safe and protected from harm. The provider had already started to take action to address these concerns, including reviewing their policies and procedures, further staff training, and reviewing care plans. The management team had a strong commitment to improving the service.

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.

There was an open culture at the service and staff told us they felt supported by the registered managers and were able to go to them with any concerns. The management team were not averse to challenging any shortfalls in practice and had worked hard to embed an improved culture within the service. The management team said they would be working alongside staff to identify concerns and to help shape the culture of the service and ensure staff had a good understanding or person centred care.

The management team encouraged people and relatives to express views and concerns. They listened and acted on them to help shape the service and culture. Staff were encouraged to raise any concerns or to challenge any poor practices. Staff were also encouraged to provide feedback, not just at formal team meetings, but at any time, the manager promoted an open-door policy.

The provider and the registered manager were keen to continue to embed a person centred culture within the service. The management team understood the context in which they deliver care and treatment. The management team was committed to developing the skills, knowledge, experience, and credibility to lead effectively. The provider spoke with integrity, was open, and recognised the improvements they needed to make.

The management team was aware of their roles and responsibilities and the lines of accountability. However, the management did not always follow the regulations, best practice guidance, or their own policies and procedures.

The management team were open and honest and were keen to develop a culture where staff felt they could speak up and their voices would be heard. Staff had access to the provider's whistleblowing policy. This helped raise staff awareness of how to report unsafe practices. Staff were confident their concerns would be listened to. 

Staff told us they felt supported in their roles, felt comfortable raising concerns, and felt listened to. Comments included, “The manager is fair and approachable,” and another member of staff said, "They felt able to raise concerns to the manager and that they would be listened to.”

The provider ensured people were not treated unfairly because of any characteristics that are protected under the legislation. Through talking to people, relatives, staff and members of the management team, we were satisfied care and support was delivered in a non-discriminatory way and the rights of people with a protected characteristic were respected. Protected characteristics are a set of nine characteristics that are protected by law to prevent discrimination. For example, discrimination based on age, disability, race, religion or belief and sexuality.

Staff were trained in equality and diversity and there was an up to date policy.

Throughout the inspection the registered manager was honest and open with us. They acknowledged the shortfalls identified at this inspection and were eager to put processes in place to ensure people receiving care and support were safe and protected from harm.The registered manager was able to give examples and describe where action had been taken following an incident and lessons learned. For example they had provided further training for staff and reviewed their policies and procedures in relation to missing persons because of a recent incident.

While people we spoke to said that they were generally happy with their care, our assessment found elements of care did not meet the expected standard. We identified a breach of the legal regulations. At the last inspection, some of the provider's governance systems required improvement to ensure people continued to receive good quality and safe care. At this inspection, we found the provider's governance and quality assurance systems needed further improvement. Management did not always follow the regulations, best practice guidance, or their own policies and procedures. This impacted their ability to meet the fundamental standards and placed people at risk of harm. There were systems in place to monitor the quality and safety of the service provided. These systems needed to be more structured, embedded, and sustained to ensure they remained effective. However, the registered manager and provider understood their responsibilities to keep CQC informed of events that may affect people and care delivery. The registered manager encouraged candour through openness and frank discussions.

While the people we spoke to expressed that they were generally happy with their care, our assessment found elements of care did not meet expected standards. Most of the relatives spoken with felt the service was well managed. Relative’s comments included, “Overall the management and company are very good. I know the manager and they are always helpful. I would recommend this company. “I know the manger. I think the company is well led and managed. I cannot fault the service and I would recommend them.”

The provider acknowledged the service had received concerns from the local authority, relatives and staff. They had taken action to address these concerns.The management team told us they had responded to the concerns raised by the local authority, staff, and relatives. They told us the senior management team would be working alongside staff and additional training would be provided.

The local authority shared concerns about the safety of people and the quality of care provided. Their concerns related to pressure sores, the quality of care provided to people, and the provider's policies and procedures not being robustly implemented. At the time of our visit, the service had agreed to a voluntary embargo on new referrals to the service to allow them to strengthen their policies and procedures.

Management did not always follow the regulations, best practice guidance, or their own policies and procedures. This impacted their ability to meet the fundamental standards and placed people at risk of harm. There were systems in place to monitor the quality and safety of the service provided. These systems needed to be more structured, embedded, and sustained to ensure they remained effective.

The provider acknowledged the service had received concerns from the local authority, relatives, and staff. We found the systems in place to monitor the quality and safety of the service provided required improvement. However, overall staff gave us positive feedback about working at the service. Comments included, “Yes, it is a good place to work. Enabling, atmosphere helps you grow in the profession. If you want to pursue an NVQ, you are encouraged to do so. Colleagues have a positive mindset.” Another person said, “Yes, definitely. The company makes things easier for us. They respond to staff feedback, such as when suggesting extending the time spent with a person due to their needs. The company will liaise with other people to ensure this can be done. This in turn can make the person feel more comfortable.”

Throughout the inspection the registered manager was honest and open with us. They acknowledged the shortfalls identified at this inspection and were eager to put processes in place to ensure people receiving care and support were safe and protected from harm.The management team understood their duty of candour, to be open and honest when things went wrong. They were committed to improving the service. The management team told us they had responded to the concerns raised by the local authority, staff, and relatives. They told us the senior management team would be working alongside staff and additional training would be provided