Archived: Derwent Carers

Updated 7 May 2016

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 is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 22 February 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

The inspection team was made up of two inspectors who visited the registered location. Before the inspection, we spoke with the local authority contracting team but they had not visited the service.

We interviewed six care workers and had discussions throughout the day with the registered manager and the care co-ordinator. We inspected the care plans of five people who used the service and reviewed records, such as policies and procedures, audits, accident and incident logs and emergency plans relating to the running of the service. We looked at 11 staff recruitment files in total, having identified issues.

On the second day of the inspection we spoke on the telephone with three people who use the service and two relatives.

Updated 7 May 2016

This inspection took place on the 22 and 23 February 2016 and was announced.

Derwent Carers provides a domiciliary care service offering support and personal care to 40 adults who live in their own homes.

There was a registered manager in post at this service. 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.

Recruitment processes were not safe at this service and staff had started work before checks were completed to ensure they were suitable to work with people in their own homes. The provider had not followed robust processes to gather, verify and document appropriate information about people they employed. You can see what action we told the provider to take at the back of the full version of the report.

Record keeping was not consistently robust and did not give staff clear instructions when risk issues for people with specific conditions had been identified.

We have made a recommendation about individual risk assessments.

Although inductions were completed by staff they were not recorded or reviewed appropriately. We were told by staff that they had completed an induction and saw one person working towards the care certificate which has now replaced the previously used induction. We discussed this with the provider who agreed to ensure the process was documented clearly in future.

Staff were trained in their roles and we saw that additional training was being sourced to meet the training needs of the staff. This meant that staff had the appropriate knowledge to support people.

We found that staff were offered support at monthly staff meetings, but not through supervision, on a one to one basis. Supervision and appraisal were not used to develop and motivate staff and review their practice or behaviours. Staff needs were not identified through supervision to ensure they could have regular private discussion with their manager to raise concerns or review their personal development.

We have made a recommendation about staff supervision.

People who use the service were encouraged by staff to live as independently as possible and people told us they felt they were treated with dignity, respect and compassion. People told us the staff approach was caring and made positive comments about the care they received

People told us they received person centred and individualised care that met their needs. However, the care plans we saw were brief and did not contain service reviews or guidance for staff around peoples specific conditions.

We have made a recommendation about the management of care plans and service assessments.

People who used the service and their relatives told us they were encouraged to raise concerns and they all knew about the complaints process. They felt confident about contacting the registered manager.

The service had not encouraged feedback from the people who used the service. None of the people we spoke with had received a survey to allow the service to adequately monitor and assess whether people had received a quality service.

The registered manager had not understood which areas should be notified to CQC and had not made any notifications since April 2014. A director had left in 2015 and the registered manager had not made a notification. However as soon as they were made aware of their omission they sent the notification. Notifications give CQC specific information about incidents which may affect the people who use the service.

Spot checks were carried out by the deputy manager to verify the performance level of staff working in people’s homes and these were recorded. The registered manager told us that medicine audits had been carried out, but they were not recorded, so this could not be confirmed. You can see what action we told the provider to take at the back of the full version of the report.