Archived: Delivering Care Direct

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

The provider had policies and procedures in relation to the Mental Capacity Act (2005) which is legislation used to protect people who might not be able to make informed decisions on their own about the care they receive. Assessments of people's capacity to consent to their care had been carried out using the principles of the Mental Capacity Act. All members of staff had received training in relation to the Mental Capacity Act. This means that people will be safeguarded as required.

There was sufficient staff to meet people's needs. All scheduled visits were covered. Supervisors were on call and were able to cover any additional visits or visits where the carer was late or ill.

Potential areas of risk had been identified for each person and plans to manage these risks had been developed. These linked to the care plans for each person. Detailed risk assessments had been completed related to hazards accessing and within peoples' homes to ensure the safety of care staff and the person they were caring for. Care plans, risk assessments and risk management plans were regularly reviewed and updated when needs changed. This meant that risks to people's health and well-being were identified and managed.

Is the service effective?

All people who used the service told us the care and support provided was good and they got on well with staff. One person said, 'The carers are very good ' they never let me down.'

People's needs were assessed and care and support was planned and delivered in line with their individual care plans. Care plans considered all aspects of the person's circumstances and were centred on them as an individual. People said that their care plans were up to date and reflected their current needs. Clear and detailed information was given on how to provide care. This meant staff could give consistent and effective care in the way people most liked to receive it.

Is the service caring?

All of the people we spoke to said staff supported their choices. They were all positive about the staff and how their care was provided. One person said, 'I can say what I want and the carers are flexible and give me the care I need how I want it'. A relative said, 'The level of care for mum is excellent ' I feel confident about the carers'.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

Information on how to make a complaint was given to people who used the service. A copy of the complaints policy was also available for staff and visitors into the office. People told us they knew how to make a complaint. We saw that the last complaint was received in August 2013 and was resolved. People can be assured that complaints are investigated and action taken as necessary.

Arrangements were in place to deal with foreseeable emergencies with on call arrangements to deal with any issues arising from visits including staff sickness.

Is the service well-led?

The service has a quality assurance system. We found that a range of internal audits were carried out regularly to regularly assess and monitor the quality of service that people received. As a result the quality of the service was continuously improving.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Feedback was overwhelmingly positive. Where shortfalls or concerns were raised these were taken on board and dealt with.

People's personal records were accurate and fit for purpose. We saw records were updated as soon as practical and were clear. Records were kept securely and could be located promptly when needed.

All the people that we spoke with told us that staff always talked to them about their care. We saw that the provider had put systems and processes in place to ensure that where people lacked mental capacity, staff would ensure that their rights were protected.

All the people that used the service and their relatives told us that their needs were being met. One person told us, 'I know what is in my care plan, we discussed it and I agreed to it and the care is provided.' We found that people received the care they needed in a safe way.

All the people that we spoke with said that they felt safe with the care workers that supported them. We saw that the provider had taken steps to ensure that people using the service would be protected from abuse.

All the people that we spoke with told us that the care workers were caring and competent. We found that staff were well supported to carry out their role to a good standard.

Everyone that we spoke with had no hesitation in telling us that they were receiving a good standard of care and support. One person using the service told us, 'I am really pleased with them, they are very good.' We found that the provider had systems in place to ensure that the service was monitored effectively.

People and their relatives said that staff always asked their consent before providing care. One person said, 'They ask me want I want done and if I think they are not doing it right I tell them.' We found that the provider did not have appropriate systems in place to ensure that people agreed to their care.

People told us that they were happy with the care they received. One person told us, 'They are very good and flexible and will change days to suite me. I am very pleased with the care.' We found that people's needs were being met.

We found that systems were in place to ensure that people were protected from cross infections whilst they were receiving care.

People told us that they received a reliable and flexible service. We found that there were enough qualified, skilled and experienced staff to meet people's needs.

People using the service and their relatives were confident that should they raise a concern it would be listened to and addressed.