We carried out a review of the data available to us about DCK Care Ltd on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about DCK Care Ltd, you can give feedback on this service.
DCK Care Ltd is a domiciliary care agency providing personal care to older and younger adults. The service supported 22 people at the time of the inspection. Not everyone who used the service received personal care. The Care Quality Commission (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 12 people receiving regulated activity at the time of the inspection.
People’s experience of using this service and what we found
Risks to people were assessed and monitored. However, risk assessments needed further improvement to ensure risks were clearly mitigated. People's prescribed medicines were recorded in their care plan and any support required to take them. However, we found some care plans to be unclear.
People told us call times and lengths had improved and they felt safe with staff. Staff were recruited safely. Staff were trained and well supported. Safeguarding processes had been reviewed and action was taken to ensure people were protected from the risk of abuse and neglect. People told us staff wore personal protective equipment (PPE) when staff supported them with personal care.
People told us communication had improved, however a small number of people we spoke with told us they felt this could be better. Quality monitoring systems had been implemented and were effective to ensure the quality and safety of care improved. Issues we found during our last inspection had been addressed meaning improvements had been made. The registered manager and staff worked with health and social care professionals to ensure people’s needs were met. Staff told us the registered manager was supportive and acted on any concerns.
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 inadequate (published 10 June 2022) 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. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
This service has been in Special Measures since 27 May 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 31 March 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, staffing, fit and proper persons, governance and safeguarding.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for DCK Care Ltd on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
DCK Care Ltd is a domiciliary care agency providing personal care to older and younger adults. The service supported 20 people at the time of the inspection. Not everyone who used the service received personal care. The Care Quality Commission (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 12 people receiving regulated activity at the time of the inspection.
People’s experience of using this service and what we found
Medicines were not managed safely. Risks were not managed effectively and placed people at risk of harm. People told us call times and lengths were unpredictable. Staff were not safely recruited. Staff were not suitably trained or supported to effectively carry out their duties. Safeguarding processes in place did not protect people from the risk of abuse and neglect.
Quality monitoring systems were not used effectively in order to improve the quality and safety of care. Known issues were not addressed which meant improvements had not been made. The lack of governance measures in place and poor management oversight meant people were at risk of receiving care which placed them at risk of harm.
The provider had an updated infection control policy in place.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 12 February 2019).
Why we inspected
We received concerns in relation to staffing, training and management of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to inadequate based on the findings of this inspection.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for DCK Care Ltd on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to medicines management, risk management, staffing, recruitment, safeguarding and management of the service.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.
DCK Care Limited is a domiciliary care agency. It provides personal care to both older and younger people living in their own homes. Not everyone using the service receives regulated activity; 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. At the time of our inspection three people were receiving personal care as part of their care package.
People’s experience of using this service:
People received safe care from staff who knew them well. The registered manager also provided care and led the staff by example and had high standards. Staff shadowed the registered manager in the delivery of care before providing care independently. People had regular staff who provided care and positive relationships had been developed. People told us staff arrived on time and stayed for the duration of the call, if staff were running late they were informed of this. People had not experienced any missed or calls later than the timeframe staff were expected.
People were very complimentary of the staff who supported them, they felt staff were unrushed and provided care in a way that met their individual needs, routines and preferences. People were fully involved in decisions about how they received their care. This was by formal review meetings and in discussions with the registered manager and staff.
People’s diverse needs had been assessed and staff had guidance of how to meet people’s needs and achieve positive outcomes. People had been provided with a service user guide that provided them with information of what they could expect from the service, including advocacy information and how to make a complaint. Staff treated people with respect, dignity and encouraged independence.
Staff had received an induction, ongoing training and had regular opportunities to discuss their work, training and development needs with the registered manager.
Where people required support with their prescribed medicines and with eating and drinking, their needs had been assessed and staff had guidance of the support required.
The registered manager had policies and procedures that reflected current legislation and this supported staff in providing effective care. 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. The registered manager had developed positive links with external professionals and strived to continually develop the service, based on best practice guidance. People who used the service, relatives and staff received opportunities to be involved in the development of the service by receiving opportunities to share their views and experience.
Rating at last inspection:
This is the provider’s first rated inspection since registration.
Why we inspected:
This is a scheduled inspection based on the provider’s registration date.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.