We carried out a comprehensive inspection of this service in April 2017 when the service was rated ‘Good’. After that inspection we received concerning information about how the service was being managed, which could have affected peoples’ needs being met. As a result we undertook a focused inspection on 14 May 2018 to look into those concerns. We found that although there had been some issues with regards to topics such as staff rotas, these had been addressed swiftly. This report only covers our findings in relation to those topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Danum Homecare limited on our website at www.cqc.org.uk”

At this inspection we inspected the service against two of the five questions we ask about services: is the service safe and is the service well led. No risks, concerns or significant improvement were identified in the remaining Key Questions through our on-going monitoring or during our inspection activity, so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

Danum Homecare is a domiciliary care agency which provides personal care to people in their own houses and flats in the community. At the time of the inspection they were delivering care and support to approximately 265 people in the Doncaster area and on the Wakefield border.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People told us the service supported them in a safe way. They said that overall they were happy with the quality of the care they received, and told us staff treated them with respect and cared for them in a way which met their needs.

There were systems in place to reduce the risk of abuse and to assess and monitor potential risks to individual people. Records showed where safeguarding concerns had been identified the registered provider had taken action to investigate these to make sure people were safe.

The process for recruiting staff remained robust. This helped the employer make safer recruitment decisions when employing new staff. Staff told us they had undertaken a structured induction to the company as well as on-going training and support meetings. However, staff annual appraisals had not always taken place in a timely manner.

Where people needed assistance to take their medication this was carried out safely. Since our last inspection improvements had been made to the medication administration records which provided staff with clearer information. We also found medication records were being regularly checked to make sure staff had completed them correctly.

People were consulted about their satisfaction in the service they received. All the people we spoke with, including staff, told us that overall they were happy with the way the service was run.

Further information is in the detailed findings below.

The unannounced inspection took place on 24 April 2017. The service was last inspected in August 2014, and was rated as ‘Good’. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Danum Homecare Limited’ on our website at www.cqc.org.uk’

Danum Homecare is a domiciliary care agency which provides personal care to people in the Doncaster area. At the time of the inspection they were delivering care and support to approximately 240 people in their own homes.

The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Overall the people we spoke with were happy with the service provided. However, some people highlighted areas they felt could be improved, such as staff arriving at the correct time for each visit more consistently.

Systems were in place to keep people safe while maintaining their independence. People’s needs had been assessed prior to their care package commencing. Care records identified people’s needs and preferences, as well as any risks associated with their care and the environment they lived in.

We found people received a service that was based on their personal needs and wishes. People managed their own medication if they were able to, but staff assisted them to take their medication safely if support was needed. However, we found medication records were not always completed consistently.

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.

Staff recruitment was robust, which helped ensure staff were employed with all of the required employment checks. There was sufficient trained staff employed to ensure people received their care consistently.

Staff received periodic supervision sessions, however yearly appraisals had not been completed for all staff. The registered manager had scheduled outstanding appraisals to be completed over the coming weeks.

People had been able to raise any concerns they may have had. We saw the provider had a complaints procedure which told people how to make a complaint. We saw complaints had been investigated and responded to in a timely way.

People had been consulted about their satisfaction in the service they received. The provider also had a system in place to check if staff had followed company polices and the service was maintaining expected standards. However, the outcome of checks completed on medication records had not been formally recorded. Therefore the registered manager was introducing a new monitoring system to capture this information.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.

The inspection was announced. The last inspection took place on 8 January 2014 and was a follow up from non-compliance regarding requirements relating to workers identified in November 2013. The service became compliant in this area during the January inspection.

During the inspection we visited five people who used the service and spoke with 22 people via telephone. We also spoke with the manager, five team leaders and four care workers.

Danum Homecare is a domiciliary care agency which provides personal care to people in Doncaster, South Yorkshire. They deliver care and support to approximately 250 people in their own homes.

The service had a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

We saw there were systems in place to protect people from the risk of harm. We observed some staff responded well to people and understood their individual needs.

There were usually enough staff with the right skills, knowledge and experience to meet people’s needs. However we spoke with people who used the service and some people told us that their carers were often late and sometimes missed the call completely.

Suitable arrangements were in place to support people to maintain a healthy intake of food and drink. Staff were aware of nutritional issues and ensured these were met effectively.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. Support plans contained enough information to explained how to meet the person’s needs. People told us that they had been involved in developing their support plan and felt they contributed on an on-going basis.

We visited people in their own homes and observed staff who had developed good relationships and were respectful.

The manager told us they were confident that all staff had a good understanding of the Mental Capacity Act 2005. Staff we spoke with told us they had received this training.

Some people we spoke with said they felt comfortable raising concerns and but some did not receive follow up or feedback. Others did not feel they would be listened to.

The provider had a system to monitor and assess the quality of service provision. However this was not always effective.

We carried out this inspection because when we visited the agency in November 2013 we found the provider did not ensure appropriate checks were undertaken before staff began work. This meant people were not cared for, or supported by, suitably qualified, skilled and experienced staff. We issued a compliance action to ensure that improvements were made in order to protect people. The provider sent us an action plan of the steps they would take to ensure compliance with this outcome.

At this inspection we found improvements had been made to ensure appropriate checks were undertaken before staff were able to work with people who used the service.

We carried out this responsive inspection as we had received concerning information about the provider’s compliance with the requirements relating to the recruitment and selection of staff working for this domiciliary agency.

We found there were inadequate recruitment procedures which did not ensure the required employment checks were obtained before staff worked with people in their own homes.

We carried out a comprehensive inspection of this service on 29 July 2014. We found that the registered person did not always have regard for complaints, comments and views made by people who used the service. This was in breach of regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We also found that the registered person did not always take proper steps to ensure that people who used the service had an up to date care plan which reflected their needs. This was in breach of regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches we had found. We undertook this comprehensive inspection on the 27 and 28 August 2015 to check that they had followed their plan and to confirm that they now met legal requirements. The provider was given 48 hours’ notice of the visit to the office in line with our current methodology for inspecting domiciliary care agencies.

This report covers our findings in relation to the comprehensive inspection on 27 and 28 August 2015. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Danum Homecare Ltd on our website at www.cqc.org.uk’

Danum Homecare is a domiciliary care agency which provides personal care to people in Doncaster, South Yorkshire. They deliver care and support to approximately 270 people in their own homes.

There is a registered manager who? manages the day to day operations of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us they felt safe in their homes and staff were available to offer support when needed to help them maintain their independence. One person told us, “The staff are very good. They pop in to make sure I am safe; sometimes they will stay for a chat which is nice.” A friend of the person we spoke with said, “My friend gets on well with the carer workers and would not be able to stay at home without their support.”

People’s needs had been assessed before their care package commenced and they told us they had been involved in formulating and updating their care plans. We found the information contained in the care records we sampled was individualised and clearly identified people’s needs and preferences, as well as any risks associated with their care and the environment they lived in.

We found people received a service that was based on their personal needs and wishes. Changes in people’s needs were identified and their care package amended to meet their changing needs. Where people needed support taking their medication this was administered in a timely way by staff who had been trained to carry out this role.

We found the service employed enough staff to meet the needs of the people being supported. This included care workers who visited people on a regular basis. People who used the service raised no concerns about how the service was staffed. The majority of the people we spoke with confirmed they had the same group of care staff most of the time.

People were able to raise any concerns they may have had. We found the systems to encourage people to raise any concerns they might have had showed improvements from when we last inspected the service. We saw the service user guide included ‘how to make a complaint’ This was written in a suitable format for people who used the service. One person said, “No complaints, the carers always see if there is anything I need doing and I would recommend them to anyone.”

People were encouraged to give their views about the quality of the care provided to help drive up standards. Quality monitoring systems had improved since our last inspection and the registered manager had overall responsibility to ensure lessons were learned and action was taken to continuously improve the service.