Direct Care (Kent)

Updated 19 June 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had two managers registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 27 May 2021 and ended on 02 June 2021. We visited the office location on 27 May 2021.

What we did before the inspection

We reviewed information that we had received about the service since the last inspection. We sought feedback from the local authority which was reviewed when received. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and one relative about their experience of the care provided. We spoke with five members of staff including the two registered managers and three care workers.

We reviewed a range of records. This included three people’s care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 19 June 2021

About the service

Direct Care (Kent) is a domiciliary agency providing care and support to people in their own homes. 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. At the time of the inspection they were providing personal care to 19 people.

People’s experience of using this service and what we found

People told us, “As far as I’m concerned there is nothing they could do better. They are all marvellous. They encourage me and can pick up if you’re not feeling so grand.”

People were supported by a core staff team that enabled them to form good professional relationships. People we spoke to, and evidence reviewed, supported people had care from regular staff.

Risks to health and safety of people were appropriately assessed. Plans and guidance were in place for staff to mitigate these. Peoples medicines were managed in safe ways and there were clear policies in place to ensure this continued.

The registered managers had completed comprehensive background checks of staff before they started work with a fully supported induction process to ensure staff were confident to support people. Staff received appropriate training and received regular supervisions and appraisals. The registered managers completed unannounced supervisions to ensure care staff were working to their standards.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People’s care plans were detailed and person centred. Care plans were regularly reviewed throughout the year and were reviewed if changes in peoples needs were identified.

There was a clear management structure in place at the service and people and staff we spoke with were able to tell us the processes for raising concerns or complaints. Feedback about the registered managers was that they were approachable, fair and reactive to things raised to them.

Rating at last inspection and update

The last rating for this service was requires improvement (published 31 December 2019) and there were multiple 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.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 14-15 November 2019. 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 Regulation 12 (Safe Care and Treatment), Regulation 17 (Good Governance) and Regulation 18 (Staffing).

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.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement 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 Direct Care (Kent) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.