About the service:

Absolute Dignity Care ltd is a domiciliary care agency. It provides personal care to older people, including people living with dementia, people with sensory needs, physical disabilities, learning disabilities and mental health living in their own homes. Not everyone using the service received the regulated activity of personal care. CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection eight people were receiving personal care as part of their care package.

People’s experience of using this service:

Risks associated with people’s needs had either not been assessed and planned for or the guidance available to staff, was not sufficiently detailed. However, people were positive how staff managed any known risks and staff were found to be knowledgeable of the action required to keep people safe. This therefore indicated this was a recording issue.

Where people received support with their medicines staff did not have guidance of the administration of medicines prescribed to be taken ‘as required’. Whilst staff had received training in the administration and management of medicines, the registered manager had not assessed their competency.

People described staff as being experienced and competent. Staff had received training the provider had identified as required. We made a recommendation in the training of staff in manual handling. Staff had not received opportunities to review their work, training and development needs with the registered manager.

People were cared for by staff who had completed safe recruitment checks on their suitability to work with people. The registered manager was in the process of recruiting additional staff that would enable them to concentrate on the management and development of the service. Staff had not been provided with an identification badge to protect people from unauthorised staff.

Guidance for staff in people’s care plans were inconsistent in the level of detail provided. The Accessible Information Standard was not fully complied with because people’s sensory and communication needs had not consistently been assessed and planned for. Assessment of people’s needs, did not fully include the protected characteristics under the Equality Act 2010.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, best interest decisions had not been recorded following an assessment that identified a person lacked mental capacity to consent to their care. The registered manager was not aware of the action required should a person be restricted of their freedom and liberty.

We made a recommendation about the application process to the court of protection.

People were very positive about the care they received and the approach of staff. Staff were unrushed and stayed for the duration of the call and if they were running late, they were informed of this. People received care from regular staff they had developed positive relationships with and no person had experienced a late or missed call.

Communication with people and their relatives were good and the electronic system used to monitor calls and care provided worked well. However, reviews and opportunities for people to feedback about their experience of the service was informal.

Rating at last inspection:

This is the provider’s first rated inspection since registration.

Why we inspected:

This is a scheduled inspection based on the provider’s registration date.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit at the next scheduled inspection. If any concerning information is received we may inspect sooner.