Archived: Exeter Domiciliary Care

All of the people who use the service we talked to told us they were very happy with the quality of care they have received from the care workers. Comments included 'They are all wonderful!' and 'I couldn't wish for better!' They told us that their regular care workers always treated them with respect and kindness. One person said the care workers were 'Like my own daughters ' they are lovely!'

Some people told us about problems they have had with missed visits, or visits from care workers much earlier or later than the time they expected. Some people told us they had telephoned the agency office many times but the problems had not been addressed. Comments included 'The office don't seem to care.' Some people also told us that they received timetables every week to let them know who will be visiting them but often the information they were given was incorrect.

Before this review we also received information from Guinness Care and Support following their recent quality assurance audit of the agency. They had identified a number of problems and concerns including missed or late visits and they had drawn up an action plan to address these. They told us they hoped to complete the main points on the action plan by November 2011.

We looked at five care plan documents held in the agency office, and the following day we visited the people in their homes to find out if the care workers were given sufficient information about the tasks each person wanted them to carry out. We found that the care plans did not give care workers sufficient information about the tasks, or how the person wanted them to carry out the tasks. However, most people told us that they had a regular group of care workers who knew them well and understood how they wanted to be assisted.

Two people told us that their only complaint was when the agency changed their regular care workers. New care workers did not support them in the same way as their regular care workers. The manager showed us new care plan documents they planned to introduce. We were told that the level of information about each person's care needs will be improved when the new documents are introduced and this will help improve consistency of care when people experience changes of care workers.

We looked at the procedures followed by care workers when assisting people with their medications. The records we looked at showed that the agency had failed to carry out robust risk assessments on medicine administration before the service began. Care workers had not been given any information about any risks associated with medicines they were expected to administer, including any special storage or administration instructions. The records of medicines administered by care workers did not show what medicines had been administered. This meant that people were at risk of a range of potential medication errors, including overdose or under dose. We talked to the manager and one of the team leaders who said they would address this as a matter of priority and we will be following this up to make sure people are no longer at risk of medication error.

People told us they were satisfied that the agency had taken care to recruit suitable care workers, and to ensure they had the training they needed to meet people's care needs. We looked at the agency's records of recruitment and training and we found that there were some weaknesses in the way care workers had been recruited. The level of training and support provided to care workers was found to be satisfactory.

At the time of this review the manager had only been in post for a few months and he was not registered with the Commission. He also had responsibility for the management of the Torbay and Cornwall branches. He assured us that an application for registration will be submitted in the very near future. This will enable us to check on his fitness to manage the service, and also to check the suitability of the management arrangements.