Dinarie

Updated 13 November 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The 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.

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.

What we did before the inspection

We reviewed information we received about the service since the last inspection. We sought feedback form the local authority. We spoke to four relatives. Due to the Covid-19 pandemic and in order to minimise our time spent in the office, we requested that some documents be sent to us by e-mail. For example, policies, procedures, business and contingency plans and details of staff training.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We visited the office on 11 October 2021 and spoke with the registered manager and deputy manager. We looked at a range of records including three care plans, medicine records and three staff personnel files. We looked at records concerning the governance of the service including complaints, compliments and auditing processes.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We were not able to speak to people because of their poor health. We spoke with four members of staff and two professionals.

Updated 13 November 2021

About the service

Dinarie is a domiciliary care agency that specialises in providing care and support to people who are Receiving end of life support. The agency provides personal care to people living in their own homes. At the time of the inspection, care was being provided to 10 people all of whom had complex health needs and some of whom were living with dementia.

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

The service was new and had only been supporting people for nine months. Some of the documentation we saw was incomplete and some forms were still being developed. For example, risk assessments and mental capacity assessments. Auditing processes were in place but needed time to fully embed so that meaningful conclusions could be made. The registered manager maintained complete oversight of the service and knew people, relatives and their staff well. However, there was a need to support the role to allow the registered manager time to devote to management tasks. The service had recently appointed a deputy to support the registered manager.

Support for people was person centred and everyone held the registered manager in high regard. The registered manager was aware of their responsibilities under the duty of candour. Feedback had been sought from people and relatives and the registered manager spoke with all staff daily.

People were safe and protected from harm. Staff understood safeguarding and were able to tell us the actions they would take in the event of emerging risk. Staff understood risk and what this meant for people they cared for. Staff had been recruited safely and completed an induction process before working independently. There were enough staff working each day and no care calls had been missed. Most people had support from their families for medicine administration but where the service helped, all details were correctly recorded. The service had policies and procedures for the safe management of infection prevention and control. Policies were in place for the recording of accidents and incidents.

The registered manager completed thorough pre-assessments with people details which formed the basis of people’s support plans. Most people were supported by family with their nutrition and hydration needs but staff sometimes helped if needed. Staff had received mental health and dementia training and understood the importance of gaining consent from people. 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; the policies and systems in the service supported this practice.

Staff were caring and treated people in a dignified way. Staff supported family members and loved ones in caring for their relatives as they approached the end of their lives. People’s privacy was respected and their independence promoted. Staff did not have rigid time restrictions when supporting people and staffing schedules enabled staff to spend as long as was required with people.

No complaints had been recorded but a copy of the complaints policy was available to people and relatives. At the time of the inspection no one had specific communication needs but the registered manager advised us that they had used electronic devices to help people to write down or listen to messages. The service specialised in end of life care. All staff were trained in end of life care and were able to tell us the important aspects of caring for people at this important time of their lives. Importantly, support was also provided to families and loved ones as part of the overall package of care.

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

Rating at last inspection

This service was registered with us on 16 June 2020 and this is the first inspection.

Why we inspected

This was a scheduled inspection on a previously unrated service.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.