Quality Care Services (Derbyshire) Limited is a domiciliary care agency providing personal care to 161 people across Derbyshire. 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.People’s experience of using this service:
Risk assessments associated with people’s care were in place; however, they were not always sufficiently detailed to provide staff with the guidance needed to reduce the risk to people’s health and safety. Environmental risk assessments were in place, but these did not include how to make people safe in an emergency.
People told us they felt safe with staff; however, some raised concerns about staff punctuality. The provider ensured the local authority were notified of any concerns about people’s safety. People’s medicines were managed safely. The risk of the spread of infection was safely managed. The provider had systems in place to help staff to learn from mistakes.
Quality assurance processes were in place; however, these were not always effective in highlighting and addressing the concerns we have raised during this inspection. The registered manager and registered person had limited knowledge of the regulatory requirement to report safeguarding concerns to the CQC. People’s views were requested and used to improve the quality of the service provided. Some people felt office-based staff did not always communicate effectively with them. When people had met or spoken with the registered manager, they found her to be supportive and approachable.
We have recommended that the provider reviews the CQC guidance for the reporting of notifiable incidents and ensures these processes are understood and followed by the registered manager.
People received care in line with their assessed needs. Most staff training was up to date and staff received supervision of their practice. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People received the support they needed to maintain a healthy diet. People had access to other health and social care agencies where needed.
People and relatives found the staff to be kind and caring. People felt they were treated with dignity and respect, especially when personal care was provided. People were encouraged to do as much for themselves as possible. People were able to make decisions about their care and they felt staff acted on and respected their wishes. People’s records were stored securely to protect their privacy.
People’s care records contained guidance for staff on how to support them in their preferred way. However, some records were more detailed than others. People were provided with information in formats they could understand, this reduced the risk of people being discriminated against because of a disability or sensory impairment. Complaints were responded to in line with the provider’s complaints policy. People were not currently receiving end of life care. End of life care was to be discussed with people during reviews of their care.
Rating at last inspection and update: The last rating for this service was Good (published 16 January 2017). The service’s rating has now changed to Requires Improvement.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.