This inspection took place on 9 January 2019 and was unannounced.

This was the first comprehensive inspection carried out at Direct Care Works Ltd since they registered with CQC in November 2017.

Direct Care Works Ltd is a domiciliary care agency. By domiciliary care agency (DCA), we mean services that provide personal care (and sometimes other support) to people living in ordinary houses and flats in the community. DCAs vary significantly in size, scope, and service user bands. Most work with older adults, some with younger disabled adults, and some also work with children. They range in size from small to very large, measured in terms of numbers of staff, people provided with care and support, and the settings they live in). Direct Care works Ltd. provides a service to people living with dementia, children and adults who misuse drugs or alcohol. On the day of our visit, there was one person receiving personal care in their own home.

The service had 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.

Risk assessments were in place and reviewed regularly; The person received their care as planned to mitigate their known risks.

The person received their care from a consistent staff team. Relatives found this valuable.

Staff had received training and support to carry out their roles. Staff understood their roles and responsibilities to safeguard people from the risk of harm.

The provider had robust recruitment procedures in place.

The person was supported to access relevant health and social care professionals. There were systems in place to manage medicines in a safe way.

Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA). Staff understood how to meet the person’s best interests where they were unable to express verbal consent.

Family members were involved in the planning of the person’s care where the person was unable to be involved. Care plans were person centred and updated regularly.

The person’s privacy and dignity was protected and promoted. Staff had a good understanding of the person’s needs and preferences.

Relatives knew how to raise a concern or make a complaint. There was a complaints system in place and relatives were confident that any complaints would be responded to appropriately.

Staff and relatives thought the service was well run. The registered manager and office manager had analysed the care provided to people and identified areas of improvement.