This inspection took place on 12 April 2018. The provider was given 48 hours' notice because the location provides a domiciliary care service. At the time of the inspection Dendera Limited provided domiciliary care and support for fifteen people in their own home that were receiving personal care. The service worked mostly with older people all of whom were living in the same London borough and all receiving a short term re-ablement service. Re-ablement is a rehabilitation service designed to help people regain independence, usually after a period of time in hospital. The service worked with people for an average of four weeks on a targeted re-ablement programme in order to assist people to regain their independence. If the service thought that people were in need of more weeks they raised this with the purchasing authority and their views were listened to, as we saw in one example for a person currently using the service. Aside from this the vast majority of people needed no more than the four week programme and in one recent case a person had themselves ceased using the service as they did not feel they required it, which was assessed and acted upon. CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.This was the first inspection of the service since registration in April 2017.
There was a registered manager in post. A registered manger is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of law; as does the provider. The registered manager was present during the inspection.
Procedures relating to safeguarding people from harm were in place. Staff we spoke with understood what to do and who to report it to if people were at risk of harm. Staff had an understanding of the systems in place to protect people who could not make decisions and were aware of the legal requirements outlined in the Mental Capacity Act 2005. No one using the service at present lacked capacity.
The service operated safe staff recruitment procedures and ensured that all staff were suitable for the role before beginning any care work.
Medicines were managed safely and the service checked people could do this independently. Assistance, by way of asking people if they had taken their medicines, was provided to some people if this was needed until it could be verified that people could manage their medicines independently and safely without being reminded.
Risk assessments provided staff with guidance on how to mitigate people’s individual personal risks. Risks had been clearly identified and risk reduction measures were identified and acted upon.
Staff were provided with a suitable induction as well as on-going regular training and supervision to support them in their role.
People were involved in planning their care and had regular reviews to gain their opinion on how things were. People and relatives felt that they were treated with dignity and respect. Care plans were person centred and included information on how people wanted their care to be delivered as well as their likes and dislikes.
People and relatives were provided with information on how to make a complaint and their views were obtained and acted upon.
People who used the service, relatives and stakeholders had a range of opportunities to provide their views about the quality of the service. The provider regularly monitored the care of people as although the service provided to each person was short term the provider saw it as important to make regular contact to monitor the quality and effectiveness of the service. The provider was also required to report back weekly to the local authority that commissioned the service about progress of each person and the effectiveness of the service in achieving the goal for people to regain their independence.
Further information is in the detailed findings below.