About the service: Southeast and South Derbyshire Home Care is a domiciliary care agency, it provides personal care to people living in their own houses and flats and within an extracare facility. The service supports younger adults, older people, people living with dementia and people with physical disabilities living in their own homes. Some people received a short term service following a period of hospitalisation. At the time of this inspection 219 people were using the service.

People’s experience of using this service:

Quality monitoring systems were in place, although these were not effective to ensure people received safe and effective care.

People were not protected from harm because care plans and risk assessments had

not always been completed to ensure staff knew how to provide their care.

Care was not always reviewed in a timely way to reflect how people’s needs had changed and how they wanted to be supported.

Systems were not in place to ensure where calls to people had been missed, this was identified as calls were not always monitored.

Where people were at risk or harm or potential abuse, this had not been suitably reported to the safeguarding team to ensure the necessary action was taken.

Systems were not in place to ensure staff understood what medicines people needed support with.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people were no longer able to make decisions about their care, assessments had not been completed to demonstrate how decision were being made in their best interests and in the least restrictive way.

Accidents and incidents were recorded but where lessons could be learnt from incidents, this was not shared with the staff team to reduce the risk of re-occurrence.

People did not always have information in a format that was meaningful to them. Where people needed support to communicate, this was not always recorded to ensure staff could support them.

Where people knew staff, they felt comfortable receiving personal care. However, sometimes they received care from staff they did not know.

People were supported to access health care services where needed and staff monitored people’s health needs.

People knew how to complain and felt confident that their concerns would be listened to or acted upon.

There were sufficient numbers of staff on duty to meet people’s care needs who were suitably recruited to work with people.

Staff understood infection control procedures and people were confident the staff followed good practices.

Staff felt they received training to update their skills and knowledge to deliver effective care.

People had a choice of what to eat and drink and when.

People continued to receive healthcare from health professionals to ensure they remained well. Appointments and outcomes were recorded, and information shared.

People could share information about how they would like to be supported towards the end of their life.

Where people knew staff who provided their care, they felt received respectful, dignified care and the staff were kind and caring.

People and staff could comment on service delivery to influence how the service was developed.

Rating at last inspection: Good (published November 2016)

Why we inspected: This inspection was brought forward as we had concerns about how the service was managed and the systems in place to ensure people received safe and effective care.

Enforcement: Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up: The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to canc

We inspected this service on 12 and 13 October 2016. This was an announced inspection and we telephoned the week prior to our inspection in order to arrange home visits and telephone interviews with people. The service provides care in people’s homes to older people and people with debilitating illness and long term conditions such as dementia. The service is available in the Erewash region of Derbyshire. At the time of the inspection 146 people were being supported by the service.

This was the first inspection visit since the service registered with us in October 2014.

There was a registered manager in post. 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 felt safe and staff knew how to raise any concerns to protect people from harm. We saw that risk assessments were in place to provide guidance to the equipment which was provided. When required staff had raised concerns and other equipment had been provided to support people. People told us they received support from a regular group of carers. The service ensured there was a thorough recruitment check undertaken before staff commenced their employment. When medicine support was required we saw that it was provided to meet individual’s level of support.

Staff had received training to support people’s needs and new staff received an induction to enable them to be confident in their role. This involved a training package, support from experienced staff and continued support. Staff knew about people’s individual capacity to make decisions and understood their responsibilities to support people and when relevant best interest decisions had been made. Where required people received a choice of meals and records were maintained to support people’s nutrition. People were supported to maintain their health and wellbeing with ongoing healthcare support.

People had established positive caring relationships with the staff. People were encouraged to be independent and have their needs met in a way they choose. Respect for the person was maintained and people’s dignity was upheld.

Assessments and person centred care plans had been completed to identify the care needs of the person. The service supported people to pursue their hobbies and interests. A complaints procedure was available and any concerns raised had been addressed.

The service had an open approach and clear values which staff felt supported them in their role. People were given the opportunity to provide feedback on their care and the service. A range of audits were used to monitor the quality of the service and were used to develop improvements to the service.