We carried out a review of the data available to us about Derby City Council Home First 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 Derby City Council Home First, you can give feedback on this service.
Derby City Council Home First is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides short term support and rehabilitation to people who are recovering from injury or illness. The service therefore helps prevent long hospital admissions or short stays in a care facility until the person is independent following ill health. The service enables people to receive all necessary support and care in their home until they are independent.
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 our last inspection we rated the service as overall 'Good'. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. At the time of our inspection, 16 people were in receipt of personal care and support with Home First. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service had a registered manager. 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.
People and relatives told us staff worked in a safe and reliable way. The provider followed appropriate procedures to ensure people were safeguarded against harm and abuse. Staff understood and were trained to know about different types, and signs, of abuse. They also knew the necessary actions they needed to take if they had any concerns.
There were suitable and sufficient staff to meet people’s needs safely. People’s medicines were managed and handled in a safe manner. There were systems in place to learn lessons when things went wrong.
People’s needs were assessed and fully reviewed before they received any personal care and support. People told us that their healthcare and nutritional needs were met by staff who knew them well.
Staff had regular training, supervision and appraisals. They confirmed that that were supported to deliver an efficient and personalised service. People were supported to access healthcare services where this was required.
People were supported to have maximum choice and control of their lives and daily routines. This was undertaken in the least restrictive way possible, to enable independence. Policies, procedures and systems in place at the service supported these practices.
People told us they found staff caring, kind and considerate. They felt that staff listened to them and fully included them in the care planning process. People’s culture religious and cultural needs were recognised and taken into consideration.
People confirmed that their care and support was responsive to their needs. Staff were knowledgeable about people’s preferences and their routines, ensuring they received personalised support. Care and support plans were regularly reviewed, even during very short periods of support, to make certain routines were meeting people’s needs.
People and relatives knew how to raise concerns and make a complaint, relevant information was provided at each referral. One person said that staff had supported them when they were not completely satisfied and encouraged to make a complaint to enable staff to follow up and improve matters.
While people’s end of life care needs was not specifically undertaken at the point of referral, the registered manager explained that if this occurred during a care package, the person would continue to receive care and support from Home First.
The registered manager and staff team had a good understanding of the needs of people who used the service and of their responsibilities in notifying us of any incidents. There were systems in place to monitor and check the quality and safety of the service being provided.
Derby City Council – Home First community team is a domiciliary care service providing care and support to older people who may have a physical disability or are living with dementia. The team provide short term care supporting people in their own homes, helping them to regain confidence and independence following a deterioration in their health. Referrals are received from ward staff where a person had been admitted to hospital for three days or less, and the GP or intermediate care service where a hospital admission can be avoided if possible. This service is available to people between 7am and 11pm, seven days a week. At the time of our inspection there were 46 people using the service.
There was a registered manager in post. 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.
Risk assessments and support plans had been developed with the involvement of people. Staff had the relevant information on how to minimise identified risks to ensure people were supported in a safe way.
People received their medicines as prescribed and safe systems were in place to manage people’s medicines.
Recruitment procedures ensured suitable staff were employed to work with people who used the service. Staff told us they had received training and an induction that had helped them to understand and support people better.
The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005. Staff knew about people’s individual capacity to make decisions and supported people to make their own decisions.
People’s needs and preferences were met when they were supported with their dietary needs. People were supported to maintain good health and to access health care services as required.
People told us that staff treated them in a caring way and respected their privacy and supported them to maintain their dignity. The delivery of care was tailored to meet people’s individual needs and preferences.
The provider’s complaints policy and procedure were accessible to people who used the service and their representatives. People knew how to make a complaint.
Suitable arrangements were in place to assess and monitor the quality of the service, so that actions could be put in place to drive improvement.
We used the information we gathered to answer our five key questions.
Is the service safe?
People told us they felt safe and had no concerns regarding the support workers that supported them.
People told us that the support workers supported them in a dignified way and ensured their rights were respected. Comments included 'The staff always give me a choice and encourage me to be as independent as possible.'
Information in people's care files included instructions to staff regarding accessing people's homes and the support they required. This ensured people using the service were not placed at risk.
Is the service effective?
People's care packages were tailored to meet their needs and preferences and demonstrated that they were involved in the development of their care package.
Is the service caring?
People using the service and their relatives told us that they were happy with the support they received from support workers. Comments from people using the service included 'The support workers work with me, they are all very nice,' 'All the support workers have been very caring' and 'The carers are lovely and supportive.' Comments from relatives included 'The carers are always polite' and 'I cannot fault the carers they are brilliant and meet my relative's needs.'
When speaking with support workers it was clear that they had a good working relationship with the people they supported and understood their needs and preferences.
People's preferences and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
Is the service responsive?
People using the service told us that they knew how to make a complaint if they were unhappy. The team manager confirmed that no complaints had been made in the last 12 months.
The service worked well with other agencies and services to make sure people received care in a coherent way.
Is the service well-led?
The service has a quality assurance system, and records showed that identified problems and opportunities to change things for the better were addressed promptly. This helped to ensure that people received a good quality service at all times.
Staff were clear about their roles and responsibilities and spoke positively about the management support they received.