Archived: DIL Foundation

We gave this service 24 hours’ notice of the inspection. The inspection took place on 28 April 2015 and 26 May 2015 and was the first inspection for this service.

DIL Foundation Registered office is located on the first floor inside a newly renovated church, which is being used for the local community. The Church is located off one of the main roads of Bolton which is less than a mile away from Bolton Town Centre and Bolton Train Station.

DIL Foundation offer a range of domicilary care services, including cooking, cleaning and personal care. On the day of the inspection there were seven people using the service.

The service had a manager in place who was in the process of registering with the Care Quality Commission (CQC). 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.

We found five breaches of the Health and Social Care Act 2008 (Regulated Activities)Regulations 2014. These breaches related to setting up systems to investigate potential abuse, consent, safe recruitment of staff, suitability of management and staff support.

People who used the service said they felt safe with the carers allocated to them.

There were safeguarding policies and procedures in place but staff had little knowledge and training in this area in order to follow them appropriately. The service had no information about local safeguarding protocols in order to progress any concerns appropriately.

Although there was an appropriate recruitment policy in place, staff were not recruited safely. We saw no evidence of application forms, interview notes, proof of identification or references in staff files.

Financial transactions were not documented appropriately, according to the service’s policy. The manager agreed to implement a new system immediately.

People were not always safeguarded from harm as staff were in the habit of providing care in premises that had not always been risk assessed. The manager agreed to cease this practice immediately.

We saw that care plans included the relevant health and personal information. However, staff demonstrated little knowledge of care planning and had no understanding of how to work in partnership with other agencies.

Not all staff had undertaken an induction programme with the service and there was little evidence of staff competence assessments. There was no formal on-going training plan.

Staff with whom we spoke had little knowledge of capacity issues and best interests decision making. The service could not demonstrate that they were working within the requirements of the Mental Capacity Act (2005).

People who used the service told us they were treated with kindness and their dignity was respected. We spoke with staff members who demonstrated a commitment to providing a good standard of care.

People appreciated having their preferences for male or female carers respected. They also liked the fact that the carers were able to speak to them in their own first language as this made them more comfortable when receiving care interventions.

Information was provided to people who used the service, in the form of a service user guide. People’s views about their care delivery were sought at regular intervals.

Assessments of need were undertaken prior to the service commencing and care plans were written in response to these. People’s care needs were regularly reviewed and adjustments made when required.

People who were able to, told us they were able to express their choices and preferences. Care plans reflected these preferences, such as choice in relation to the gender of carer. However, staff had little knowledge of how to promote choice for people whose communication was limited.

There was a complaints procedure which was outlined in the service user guide. The acting manager was able to explain the process for dealing with complaints.

The management demonstrated little knowledge or understanding of the service’s policies and procedures. Staff meetings were undertaken and staff were supported via an on-call arrangement and informally. However, formal supervisions were not undertaken regularly and no supervision records were available.

There were few systems in evidence for assessing the quality of the service delivery and promoting improvement. Formal recordings needed to be implemented to ensure continual improvement to service delivery.

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve
• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.
• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.