Day and Nite Services (Kingston)

Updated 9 December 2022

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 conducted by two inspectors and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience made calls to people or their relatives.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes. This is help with tasks related to personal hygiene and eating.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

Inspection activity started on 20 October 2022 and finished on 28 October 2022. We visited the office location on 20 October 2022.

What we did before the inspection

We reviewed information we had received about the service since it had registered with us.

The provider completed 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 this information to plan our inspection.

During the inspection

We spoke with eight people and three relatives of people who used the service. We spoke with the service manager, administrative manager, a field supervisor and three care workers.

We reviewed a range of records. This included six care records, eight staff files in relation to their recruitment, training and support, and multiple medicines records. A variety of other records relating to the overall management and governance of the service were also looked at.

We requested additional evidence to be sent to us after our inspection. This included records relating to governance including policies and procedures, care plans and care worker visit schedules.

Updated 9 December 2022

About the service

Day and Nite Services (Kingston) is a domiciliary care agency providing personal care to older people in their own homes.

At the time of the inspection, there were 58 people using the service who were receiving help with 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.

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

The provider operated safe recruitment procedures and had implemented an electronic call monitoring system to monitor care worker visit times. People and their relatives told us they felt safe in the presence of care workers and said that generally their care visits were on time and they were kept informed if care workers were running late. The provider took steps to assess and manage risks to people which helped to keep them safe from harm. People received appropriate support with regards to their medicines.

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.

Feedback from people was that the service was well-led and both the quality of service and communication with the office staff had improved since the last inspection. The management team had taken feedback from the previous inspection on board to improve the frequency of staff supervision, implement digital care planning and more robust monitoring and gathering feedback form people.

However, the governance and quality assurance process were still not fully embedded and there was a lack of analysis in relation to care worker visit times. We identified some issues with the care planning and medicines records, which although the provider acted upon when we raised these with them, were not picked up by the provider’s own audits.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 14 May 2022) and there were breaches of regulation in relation to safe care and treatment, staffing, notifications and good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough improvement had been made in relation to the breach in relation to safe care and treatment, staffing and notifications and the provider was no longer in breach of these regulations. However, the provider remained in breach of good governance.

At our last inspection, we made a recommendation to the provider to review how it captures, records and follows up the concerns and complaints received in a more responsive manner. At this inspection we found the provider had acted on these recommendations and had made improvements.

Why we inspected

This inspection was carried out to look at improvements against the breaches found at the previous inspection. As a result, we undertook a focused inspection to review the key questions of safe and well-led only and also targeted to look at staffing in the key question effective and complaints management in the key question responsive.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Day and Nite Services (Kingston) on our website at www.cqc.org.uk