Background to this inspection
Updated
14 July 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 19 and 20 May 2016 and was announced. The inspection team consisted of two Adult Social Care Inspectors. At the inspection we spoke with the replacement manager and six support workers. We were unable to speak with the registered manager due to a family bereavement.
During the inspection we spoke with people who used the service and their relatives. We spoke with one at the main office and three at their home. We spoke with four relatives over the phone.
During the inspection we also spoke with one member of the local authority social work team who worked alongside the registered provider to support the people who used the service. They were complimentary about the service and had no concerns.
Before the inspection we checked the information that we held about Durham and Darlington Domically Care Agency. For example we looked at safeguarding notifications and complaints. We also contacted professionals involved in supporting the people who used the service, including commissioners and no concerns were raised.
Prior to the inspection we contacted the local Healthwatch and no concerns had been raised with them about the service. Healthwatch is the local consumer champion for health and social care services. They gave consumers a voice by collecting their views, concerns and compliments through their engagement work.
The registered provider completed a provider information return (PIR) prior to our inspection. This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information when planning our inspection.
We also reviewed; four support plans, four daily records, staff training records, five staff recruitment files, medicine administration records, accident and incident reports, safety certificates, internal communications, quality surveys and records relating to the management of the service such as audits, policies, rotas, call sheets and minutes of team meetings.
Updated
14 July 2016
The inspection took place on 19 and 20 May 2016. The inspection was announced as Durham and Darlington Domiciliary Care Agency provides domiciliary care to people in their own homes and we gave the service 24 hours’ notice to make sure there was someone at the office for the time of our inspection.
Durham and Darlington Domiciliary Care Agency is a domiciliary care service that provides personal care and support to people with learning disabilities and autism who live in their own home or supported living. The service covers the Darlington, Gateshead and County Durham area and at the time of our inspection the service supported 27 people.
The service had a registered manager. 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.
At the time of our inspection the registered manager was about to retire and was job sharing with the replacement manager as part of a handover. The new manager had applied to CQC for registration and was awaiting their interview. The registered manager was not available at the time of our inspection due to a family bereavement. Therefore the inspection was carried out with the replacement manager.
We spoke with members of the staff team including service managers and care staff who told us that the registered manager was always available and approachable. We spoke with people who used the service on the day of the inspection and their relatives.
We saw that peoples prescribed medicines and topical medicines were recorded when administered. We looked at how records were kept and spoke with the replacement manager about how staff were trained to administer medicines and we found that the medicines administering, recording and auditing process was safe.
From looking at people’s support plans we saw they were person centred. ‘Person-centred’ is about ensuring the person is at the centre of everything and their individual wishes and needs and choices are taken into account. The support plans made good use of personal history and described individuals care, treatment, wellbeing and support needs. These were regularly reviewed and updated by the support workers and the registered manager.
People who used the service received person centred support and their individual needs were respected and valued.
Individual support plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care records we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary for example: their GP and care manager.
Our conversations with people who used the service and their relatives during the inspection showed us that people who used the service were supported in their own homes by sufficient numbers of staff to meet their individual needs and wishes.
We looked at the recruitment process and found that relevant checks on staff took place and this process was safe. People who used the service chose their own staff and together with their families were a major part of the recruitment process.
People were encouraged to plan and participate in activities that were personalised and meaningful to them. People were supported regularly to play an active role in their local community, which supported and empowered their independence including; accessing local facilities and the wider community.
We saw a compliments and complaints procedure was in place and this provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. People also had access to advocacy services and safeguarding contact details if they needed it.
We found the service had been regularly reviewed through a range of internal and external audits. We saw action had been taken to improve the service or put right any issues found. We found people who used the service, their representatives and healthcare professionals were regularly asked for their views about the service via surveys.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. Any applications must be made to the Court of Protection. At the time of this inspection one application had been made to the Court of Protection and several others had gone through the process.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.