Divine Care Connections is a home care agency registered to provide personal care in people’s homes. At the time of the assessment the service was supporting 3 people with personal care. This assessment was undertaken following CQC’s new approach: https://www.cqc.org.uk/assessment . This is our first assessment of the service using the new approach. We looked at 2 key question areas (safe and well-led) and 10 quality statements within those key questions: learning culture, safeguarding, involving people to manage risks, safe and effective staffing, infection control, shared direction and culture, capable, compassionate and inclusive leaders, freedom to speak up, governance, management and sustainability and learning, improvement and innovation. The assessment, which included both on and off-site activities, took place between 16 October and 14 November 2024. We visited the office on the 16 October 2024 and spoke to the registered manager and the operations manager. We also spoke with 3 care workers. We made calls to people and their relatives and spoke with 2 people who used the service and 2 relatives. We found good outcomes for people using the service in all the areas we assessed. People were happy with the care provided and staff enjoyed coming to work at the service. The registered manager provided a supportive environment for staff to learn and provide safe quality care in a caring manner.
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First inspection of this domiciliary care agency rated Requires Improvement overall, with a breach of Regulation 17 (Good Governance) due to inaccurate call time records, a staff member working without a DBS check, and an unrecorded complaint. Effective, caring and responsive domains were rated Good, with positive feedback from people and relatives about safety, dignity and person-centred care.
Concerns (7)
criticalGovernance: “The provider's quality assurance systems and process were not effective.”
criticalStaff competency: “a member of staff was working in the office without their DBS checks carried out.”
moderateRecord keeping: “Accurate records of call times were not in place; therefore we could not be assured people received their care on time.”
moderateRecord keeping: “staff recorded identical times for log in and log out on all their visits.”
moderateMissed or late visits: “one person's care log...showed staff visited from 6.00pm to 6.55 pm. However, the ECM showed the login times at 7.00pm and 7.45pm.”
moderateComplaints handling: “concern raised by relatives had not been recorded...a complaint raised by a relative was resolved but was not recorded.”
moderateLeadership: “There was a lack of oversight from the registered manager and we reported these concerns in the well-led section.”
Strengths
· People and relatives gave positive feedback about safety and felt staff treated them well
· Staff received training, supervision and staff meetings to meet people's needs
· Provider worked within the principles of the Mental Capacity Act and obtained consent
· People were protected from the risk of infection; staff used PPE appropriately
· Person-centred care plans reflected current needs with sufficient guidance for staff
Quality-Statement breakdown (22)
safe: Staffing and recruitmentRequires improvement
safe: Assessing risk, safety monitoring and managementNot rated
safe: Systems and processes to safeguard people from the risk of abuseNot rated
safe: Using medicines safelyNot rated
safe: Preventing and controlling infectionNot rated
safe: Learning lessons when things go wrongNot rated
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawNot rated
effective: Staff support: induction, training, skills and experienceNot rated
effective: Supporting people to eat and drink enough to maintain a balanced dietNot rated
effective: Staff working with other agencies; supporting people to access healthcareNot rated
effective: Ensuring consent to care and treatment in line with law and guidanceNot rated
caring: Ensuring people are well treated and supported; respecting equality and diversityNot rated
caring: Supporting people to express their views and be involved in making decisions about their careNot rated
caring: Respecting and promoting people's privacy, dignity and independenceNot rated
responsive: Improving care quality in response to complaints or concernsNot rated
responsive: Planning personalised care to ensure people have choice and control and meet their needs and preferencesNot rated
responsive: Meeting people's communication needsNot rated
responsive: End of life care and supportNot rated
well-led: Promoting a positive culture; continuous learning and improving careRequires improvement
well-led: Managers and staff understanding roles, quality, risks, regulatory requirements and duty of candourNot rated
well-led: Engaging and involving people using the service, the public and staffNot rated
well-led: Working in partnership with othersNot rated