Care service description

Doves Healthcare Ltd is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older people some of whom may be living with dementia or physical disability. At the time of our inspection the service provided a regulated activity to six people.

Rating at last inspection

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good for Effective, Caring and Responsive but improvements were required in Safe and Well Led. The service has now been rated as Requires Improvement overall.

Medicines were not always being managed in a safe way and there was a risk that people did not receive their medicine when required. Risks assessments were not always reviewed when an incident occurred. Accidents and incidents reports were not always updated with the actions taken to reduce further occurrence.

Audits were not always robust and did not always identify the shortfalls around the completion of medicine charts and daily care records. Daily notes lacked information on the care that was provided.

Care plans did not always detail people’s backgrounds and there was at times a lack of guidance around people’s needs. We have made a recommendation around this.

Other risks to people’s care was managed well by staff. People were safe with staff and staff were aware of the safeguarding procedures. There were sufficient levels of staff on duty to ensure that people’s needs were met. There was robust recruitment processes in place before staff started work. Staff understood how to reduce the risk of spreading infections.

People’s consent was sought before care was delivered. Other than the competency checks around medicines, staff were receiving appropriate supervision that related to their role. Training was up to date for staff and staff told us that they felt supported by the registered manager.

Assessments of people’s needs were undertaken before they started receiving care. People were supported with their health needs and referrals were made to health care professionals where needed. People were provided with sufficient food and drinks when needed. No one at the service was receiving end of life care.

People were treated in a kind and caring way. Relatives told us that their family members were treated with respect and staff helped to maintain people’s independence. People were asked what care they wanted and felt involved in their care planning.

Relatives told us that they would speak to staff or the registered manager if they had any concerns. There was a complaints procedure should anyone wish to complain and we saw that complaints were investigated fully.

The registered manager continually requesting feedback from people and relatives about the quality of care. People fed back positive comments about the care. Calls were made to staff each day to ensure that they arrived at the calls. Staff consulted with outside professionals to ensure the best delivery of care. People, relatives and staff felt that the service was well managed. Staff felt supported, valued and listened to.

The registered manager had informed the CQC of significant events including safeguarding and incidents.

There are two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Further information is in the detailed findings below.

Doves Healthcare Ltd is a domiciliary care agency providing people in their own homes. They provide live-in and hourly care to people. At the time of our inspection the agency was providing support to two people, one of whom was being supported by two people twenty four hours a day due to their health needs.

The inspection took place on 26 May 2016 and was announced. This was the first inspection of the service since it registered with CQC on 03 September 2014.

The agency had a registered manager in place. 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.’

The registered manager carried out appropriate checks before recruiting staff, but records did not contain copies of photographic ID. We recommended that records be updated to include photographic ID for all staff.

Policies and procedures were in place to assess and manage risks in order to keep people safe.

Staff understood their role in safeguarding people and knew how to raise concerns. The agency had a safeguarding policy that complied with legislation. We saw that staff had all received training in safeguarding.

Medicines were administered by trained staff and in line with the instructions of healthcare professionals. Measures were in place to respond to medicine errors should they occur.

People were supported by trained staff. Staff had a thorough induction and were provided with training and development opportunities.

Care was provided in line with current legislation. Staff demonstrated a good knowledge of the Mental Capacity Act (2005) and the correct processes were followed when providing care in somebody’s best interests.

People told us that the staff who supported them were kind and friendly. Systems were in place that ensured people were matched with staff who they would get along with.

Care plans and assessments were person-centred and reflected people’s individuality.

Systems were in place for people to complain or provide feedback and compliments.

The registered manager was looking at ways to improve the service as it grows.

Quality assurance audits were being frequently undertaken through spot checks and reviews. The registered manager has plans to improve auditing procedures when the service increases in capacity.