Dunamis Social Care, a domiciliary care agency serving 25 people in Wellingborough, was rated Requires Improvement overall following a focused inspection in May 2023, down from Good in 2022. Key failures centred on unsafe recruitment practices, gaps in staff training (including MCA and disability-specific training), inadequate care plan updates, and governance systems that failed to identify the issues found during inspection.
Concerns (8)
moderateStaff training: “Staff training did not include topics staff needed to be aware of, such as training in dignity and specific health conditions.”
moderateStaff competency: “Staff had not yet attended specific training to support autistic people and people with learning disabilities.”
moderateRecord keeping: “The provider's staff records documented some staff had completed all of their induction training on the same day...this was not possible or following good practice.”
moderateCare planning: “People's care, treatment and support plans had not always been updated and did not show how people had been involved.”
moderateGovernance: “The providers quality assurance system had not picked up on the issues inspectors found at this inspection.”
moderateGovernance: “The provider did not complete the required provider information return...We will not award a rating better than 'requires improvement' for well-led.”
moderateStaff training: “MCA training was missing off the providers training records, this meant we could not be assured staff were aware of the most up to date guidance.”
moderateStaffing levels: “Staff were not always recruited safely. Recruitment systems needed improvement, as inspectors found there was no evidence to show references from staff were verified.”
Strengths
· Medicines managed safely with electronic MAR records completed and systems flagging incomplete records.
· People felt safe with staff and reported kind, compassionate care; one relative stated it was the 'Best care [our relative] has ever had.'
· Appropriate DBS checks had been completed for all staff.
· No missed calls reported and sufficient staffing levels to meet people's needs.
· Service worked effectively with healthcare professionals including district nurses for pressure area care.
Quality-Statement breakdown (15)
safe: Staffing and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsRequires improvement
well-led: Continuous learning and improving care; Promoting a positive cultureGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffRequires improvement
Dunamis Social Care, a domiciliary care agency serving 42 people, was rated Good overall following a focused inspection of Safe and Well-led domains triggered by concerns about recruitment practices. The service demonstrated safe recruitment, effective medicines management, strong governance, and a supportive management culture, improving from its previous Requires Improvement rating.
Strengths
· Safe recruitment procedures followed including ID, right to work, references and DBS checks with no concerns found
· Medicines administered safely by trained staff with accurately completed MAR records
· Risks assessed and regularly reviewed with clear guidance for staff in care plans
· Staff felt well supported by management and able to raise concerns with confidence
· Prompt action taken to address errors and communicate lessons learnt across the team
Quality-Statement breakdown (11)
safe: Staffing and recruitmentGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Preventing and controlling infectionGood
safe: Using medicines safelyGood
safe: Learning lessons when things go wrongGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: How the provider understands and acts on the duty of candourGood