Caterham Domiciliary Care Agency

Updated 15 June 2023

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and ‘supported living’ settings, so they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

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 had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

On the first day of inspection on 14 February 2023 we spoke with 7 people who used the service and 2 relatives about their experience of the care provided. We spoke with 10 members of staff including the nominated individual, registered manager, senior care workers and administrative staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. On the second day of inspection visits on 14 April 2023 we spoke with 4 people who used the service and 3 members of staff.

We reviewed a range of records. This included 5 people’s care records and multiple medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 15 June 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Caterham DCA is a domiciliary care agency providing personal care to people living in their own homes and supported living settings. The service provides support to people with a variety of health needs. At the time of our inspection there were 31 people using the service. 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. There were 14 people being supported by staff with personal care.

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

Right Support: Some areas of concern were identified with the assessment and management of risks and the effectiveness of the safeguarding policy which left people at risk of abuse. 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.

Right Care: People were receiving care and support in a person-centred way. The care promoted people’s dignity, privacy and human rights. People’s care was provided in line with their preferences and choices.

Right Culture: Some of the management oversight was not completely effective, however, other areas were. For example, we found audits including accidents and incidents and safeguarding concerns had not been effective. Whereas staff competencies were checked regularly and the registered manager had oversight of this. Staff were aware of the values of the provider and ensured people led confident and inclusive lives. Staff treated people with kindness and were caring when offering support.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 17 July 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. The provider was also issued a warning notice in relation to good governance. At this inspection we found some improvements had been made, however, some concerns were found which meant they remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The second day of an inspection visit was prompted in part due to concerns received about safeguarding service users from the risk of abuse. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding service users from the risk of abuse and good governance at this inspection. Since the last inspection we recognised that the provider had failed to keep people safe from risks and the risk of abuse. This was a breach of regulation. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.