Background to this inspection
Updated
19 November 2020
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 carried out by one inspector 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.
Service and service type
Direct Health (Stockton on Tees) is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a large service operating during the pandemic and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete 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 all this information to plan our inspection.
During the inspection
We spoke with the regional manager, care manager and administrator.
We reviewed a range of records. This included five people’s care records and several medicines records. We looked at five staff files in relation to recruitment and training. We reviewed a variety of records related to the management and quality assurance of the service.
After the inspection
Two Experts-by-Experience telephoned and spoke with 50 people who use the service or their relatives. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with 17 members of staff on the telephone.
Updated
19 November 2020
About the service
Direct Healthcare is a service that provides personal care to people in their own home. At the time of inspection approximately 375 people were supported by the service.
Not everyone who used the service received personal care. 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
Following the previous inspection in March 2019 the provider sent us an action plan. This included information about the actions they had taken to make improvements within the service.
At the last inspection medicines were not managed safely. At this inspection improvements had been made and the service was no longer in breach of the regulation safe care and treatment.
Some people and staff said that communication could be improved. Not all people said they had regular carers and they were not informed if carers were going to be late.
We have recommended that changes made to improve communication, as a result of people and staff feedback during the inspection, should be kept under review to ensure the changes are maintained.
People said they felt safe with the service they received. People and relatives said staff were kind, caring and supportive of people and their families. Comments included, “We get on famously” and “The way the workers engage with my relative is brilliant, making time for them and getting to know them”.
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.
There were opportunities for people, relatives and staff to give their views about the service. Processes were in place to manage and respond to complaints and concerns. The provider undertook a range of audits to check on the quality of care provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was requires improvement (published 8 May 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has improved to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Direct Health (Stockton on Tees) on our website at www.cqc.org.uk.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.