Archived: Hertfordshire Domiciliary Care Services

Updated 15 June 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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2014 and to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We undertook a comprehensive inspection of Hertfordshire Domiciliary Care Services on 04 May 2017. This inspection was unannounced and carried out by two inspectors. On 08 May 2017 we visited people who used the service in their own homes to ask if the care and support they received met their needs.

Before our inspection we reviewed information we held about the service including statutory notifications. Statutory notifications include information about important events which the provider is required to send us. We also attended a meeting with commissioners and safeguarding authorities regarding Hertfordshire Domiciliary Care Services on 24 April 2017 where we received feedback about the service from health and social care professionals.

During the inspection we spoke with five people who used the service. Out of the five people only four received the regulated activity of personal care. We visited and talked with a person who didn’t receive the regulated activity, however they used to be supported by the same staff who delivered this support to other people and they gave us feedback about the management of the service.

We also talked to four care and support staff, two service managers, the registered manager and the provider. We viewed three people’s support plans. We also reviewed records relating to the management of the service.

Updated 15 June 2017

This inspection was carried out on 04 May 2017 and was announced. On 08 May 2017 we visited people in their own homes to ask for their feedback about the service they received. At the last inspection of this service on 12 April 2016, the provider was found to be meeting the standards we inspected.

Hertfordshire Domiciliary Care Services provides personal care and support to people living in their own homes and supported living accommodation. There were 48 people using the service on the day of our inspection. However, only 11 of those people were receiving a regulated activity from the service. A regulated activity is registered under the Health and Social Care Act and this service is registered for the Regulated Activity of Personal Care.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. In this instance the registered manager was also the provider.

The service had experienced some staffing difficulties and had changed management structure over the last two years. As a result people who used the service had not always experienced care and support which was effective and personalised.

People told us they were overall happy with the service, the only complaint they had was about not knowing which staff member would turn up and when they would receive the care and support they needed. People told us this had no effect on their safety; however they could only plan their days after staff visited them.

The registered manager and the provider recognised that the service they had provided was not always responsive and of good quality therefore they were not taking on care and support for additional people at this time. They had implemented new recruitment processes which were more effective and since November 2016 they managed to recruit a high number of permanent staff, however there were still vacancies in staffing hours.

Staff we spoke with were knowledgeable about people`s needs and the risks involved in people`s daily living, however people`s care plans were not always reflective of their current needs. Although staff were trained in safe administration of medicines they were not always following best practice guidance when administering people`s medicines.

Staff felt that they had received better support from the management team in the past couple of months than before. They told us things had slightly improved and staffing was better; however last minute sickness or absence still caused stress and put pressure on them to cover for these.

There were systems in place to monitor the quality of the service and additional systems were being developed to help ensure the support provided was consistent. This included implementing a system where time specific calls were marked on staff`s rotas to ensure visit times were on time and for the full duration of the time allocated to people.

People told us they felt safe and trusted the staff who offered them care and support. Staff were knowledgeable about safeguarding procedures and how to report their concerns. Staff knew people well and treated them with dignity and respect.

People told us that they were supported to make their own decisions and choices which staff respected. They told us they had discussions with their key worker about their care plans and their needs. The provider had started organising meetings with people to gather their views on what they liked and disliked about the service and how to improve.