The care service provider received an overall rating of Requires Improvement
A care service provider has come under fire after a health watchdog revealed a series of shortfalls within in its caring services.
Direct Approach Care Limited registered at an address in Preston is a service that provides support with personal care to people living in their own homes. The company cares for adults living with dementia and mental health conditions and was recently inspected by the Care Quality Commission (CQC).
During the inspection it was highlighted that the service was not always safe. Information about people’s risks was not comprehensive enough and there was no evidence that the service looked for safety related themes or trends.
Direct Approach Care Limited was given an overall rating of ‘Requires Improvement’ by the CQC who found care plans need to support service users were not always up to standard. According to the report, care plans did not always identify risks to people, or record risks in sufficient detail to show how they were managed and mitigated.
Risks such as choking and behaviours that may challenge were not included in the records. It was also highlighted that staff did not always have appropriate information to support people safely.
In addition, looking our for potential risk and safety trends was also another area that was found to be lacking. Although a system was in place to record any incidents or accidents, there was no recorded oversight for identifying any trends and help prevent any future risk and reoccurrence, which meant CQC inspectors could not be assured that lessons were learnt or shared with staff.
Another area of weakness found during the inspection was medicine administration as inspectors state they could not be assured that staff had the required understanding of safe medicine administration. Not all pre-completed medicines administration record (MAR) were available for inspection.
One MAR did not contain information in-line with best practice guidance, including the person’s name, date of birth and allergy status. On some days, medicines had not been signed for correctly. These inconsistencies had not been highlighted by quality checks and it was added that the service was not clear about its responsibilities and role in relation to medicines.
There was a lack of safety and quality checks in place to ensure that people had received their medicines as prescribed. This made it difficult or impossible for the safe administration of medicine to be audited.
For effectiveness and caring categories, the services was rated good but more shortfalls were discovered with the services responsiveness. Care records were basic, incomplete and did not always adequately document people’s care and support needs, which meant people were at risk of not receiving appropriate care and treatment.
It was also found that some records contained inconsistent information- for example, about people’s mobility requirements, this meant care plans were not always accurate and did not always reflect people’s current needs. Failings in leadership were also highlighted to show how there were no systematic approach to audits and many of the checks we were told were completed were not evidenced.
Policies contained outdated information and were not reflective of current guidance- they did not contain accurate or enough information to help guide staff in their roles. Systems were ineffective in helping to drive forward improvements and mitigate risk to people and did not conform with the service’s own principles, philosophy and values as stated in their Assessment and Monitoring Policy which stated, “My home-care agency will routinely check the quality of their service. The Managers of the agency will regularly monitor the quality of the service they provide to make sure I receive the support I need.”
A spokesperson for Direct Approach Care Limited said: “Firstly the report states we was registered in 2020. However it was 5/6/2019.
“It was the first time in managing a company and the pandemic broke out and with small amounts of guidance our main priority was to keep our service users and staff safe. With the high command of care needed, we cared for many service users with terminal cancer and some of Covid.
“Due to Covid, I was on shift most days as staff were off sick or had to isolate due to family settings. The staff hired in the office and at a senior level were not carrying out their duties and not completing their roles which resulted in termination of employment. Some auditing not being carried out and and at that time I presumed this was being done.
“And the referencing wasn’t clear enough however all employees had full training and full enhanced DBS. We acted on this immediately as we were just in the process of uploading all files digitally and gathered all the evidence and input all the data and corrected all files within two days of the inspection.
“All services users was cared for and no concerns. I requested a CQC inspection 2 years prior as I wanted to know all was going correctly. But Covid pandemic unfortunately stopped the process.”
- 05:25, 4 JUL 2022