Background to this inspection
Updated
11 October 2017
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.
We undertook an announced inspection of Dorset Blue care on 29 June 2017. This inspection was done to check that improvements to meet legal requirements planned by the provider after our March 2017 inspection had been made. We inspected the service against two of the five key questions we ask about services: is the service Safe and Well led? This is because the service was not meeting some legal requirements. We undertook a further visit on 13 September 2017 and made calls to staff and people on 14 September 2017. We undertook this visit because we needed to gather further information to be confident about our judgements.
The inspection team was initially made up of one inspector. A further two inspectors undertook the second part of the inspection.
Before the inspection visits we reviewed information we held about the service. This included notifications the service had sent us. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. We looked at management information in relation to the running of the service. These were in the form of records relating to people’s individual care plans and the auditing of the quality of care provided. We also spoke with a representative of the local authority’s monitoring team. We had not requested that the provider complete a Provider Information Return (PIR) prior to this inspection. A PIR is a form that asks the provider to give some key information about the service, what the provider does well and what improvements they plan to make. We were able to gather this information during our visits.
During our inspection visit in June 2017 we spoke with three members of staff and the registered manager. We also looked at records relating to six people’s care, and reviewed records relating to the running of the service such as care records, incident and accident records and quality assurance records. Following the inspection we telephoned six people who received a service and asked them their views of the support they received from Dorset Blue Care. When we visited in September we spoke with two relatives and a person who used the service, two members of care staff and two managers. We also looked at records relating to four people’s care, two staff files, policies and procedures, meeting minutes and quality assurance documentation.
Updated
11 October 2017
The inspection visit took place on 29 June 2017 and the 13 and 14 September 2017. Dorset Blue Care is registered to provide personal care to people living in their own homes. At the time of our inspection in June 2017 the service provided personal care and support for 23 people. When we visited in September 2017 they were providing personal care to 12 people.
At our last inspection in March 2017 we took enforcement action and told the provider to make improvements to staffing, safe care and treatment and governance. We also asked them to tell us how they would improve the processes that protected people from abuse. They wrote and told us they would make immediate changes. We undertook this focussed inspection to check they had followed their plan and to confirm they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the “all reports” link for Dorset Blue Care on our website at www.cqc.org.uk.
The service did not have a registered manager at the time of our inspection. 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. A senior manager working in the service had made enquiries about adding this location to their current registration but this had not taken place.
The provider had reconsidered the quality audit systems in place. Following quality audit checks there had been improvements in care planning and risk assessments. People's care records gave staff the guidance they needed to support people safely. Minor improvements identified at the June 2017 inspection had been introduced by the September visit date.
At this inspection we found that there had been improvements with regard to the reviewing of people’s individual care records and risk assessments. One person’s records evidenced that staff knew how to meet their needs but some improvements in the written guidance to staff were required. The manager acknowledged this and made arrangements to update at the time.
The provider had reviewed its staffing levels and established that ‘zero hour ‘ contracts and a IT application had been some of the causes of people having missed visits. As a result of this review staff were offered permanent contracts so that the provider could be clear about the amount of staff available to meet their commitments. The IT application that had caused miss communication between field workers and office staff had been disabled. This meant that field workers could no longer enter onto the IT system they could not attend a visit (thinking that the system informed office staff of this) and would have to contact the office staff directly allowing office staff to organise another worker to attend to the visit. This meant a reduction in missed visits reducing the risks people faced.
Staff felt involved in service developments and identified mangers as approachable and responsive. People and relatives also felt able to talk with senior staff about any concerns and were confident that actions would be taken.
People were supported by staff who understood the risks they faced and knew how to identify and report abuse. Where concerns had been identified these had been responded to appropriately.
People received their medicines safely. Staff understood the need to balance safety with people’s wishes and independence and this was reflected in their guidance and practice.