Dynasty Brighton Branch (Domiciliary Care)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. The service was in breach of legal regulation in relation to staffing.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always have robust systems in place to ensure lessons were learnt when things go wrong. People and their relatives told us they were able to report their concerns to the staff who cared for them. However, some reported that the provider had not always been available and accessible when they needed to speak to them. They gave examples of when they had tried to contact them to raise concerns about lateness but were unable to. Staff did listen to concerns about safety and reported safety events appropriately. Whilst action was taken on major concerns, such as those in relation to safety, it was the smaller issues that were left unresolved. There was no robust analysis of these to identify patterns and trends to minimise the likelihood of reoccurrence. Whilst we did not see any evidence of people experiencing harm from this, it was an area that needed improvement.

The provider did not always work well with people and healthcare partners to establish and maintain safe systems of care. They did not always make sure there was continuity of care. We received mixed feedback from professionals who worked alongside Dynasty Brighton Branch. Some told us that the service had gone above and beyond to support people with complex needs, however others told us that communication with the service was poor, and this created a risk of people not receiving safe care. Whilst we did not see evidence of direct impact to people’s care, concerns regarding communication were consistent across all feedback.

The provider had worked with people in relation to any safeguarding matters. Although some feedback highlighted concerns about communication, we did not see evidence that this was in relation to safeguarding or that anyone had come to harm because of this. Any safeguarding concerns had been raised appropriately. Staff demonstrated a good knowledge of safeguarding, what signs to look out for and when to report any concerns. They concentrated on supporting people to protect their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider had regular contact with the local authority to discuss safety concerns.

The provider had assessed risks, and these were clearly detailed in people’s care plans. Staff were provided with clear guidance on how to minimise these risks. For example, where a person was at risk of skin breakdown, there were clear instructions on how to support people to minimise this. Staffing issues at the service had resulted in some missed and late calls, at times these were risk reviewed and those at higher risks prioritised. For example, when there was a period of extreme weather , but a person had a family member available, they were asked to support with some tasks, such as meal preparation. However, last minute sickness was more difficult to cover and staff use of the system created gaps in the oversight of the call log. Whilst we saw no evidence that people had been placed at direct risk because of this, the staffing levels and oversight of care calls needed to be improved to ensure robust risk management.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Staff told us that they felt safe completing their role and concerns about the environment were addressed as needed. People told us that staff respected their environment.

The provider did not make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development. Almost all people we spoke with raised previous issues with staff not attending when they are supposed to at times, with no explanation. One person told us, “They often arrive late, but they need to leave early to get to their next visit, so they often don’t stay for the full duration.” A relative stated, “They don’t have enough time, rush in and out in 20 mins when they should stay for an hour.” Others said, “I’d just like to be contacted if there is an issue, or staff may be late/unable to make my call.”

The call log had been completed sporadically meaning oversight of this was challenging. One relative told us they have been asked to support the person before, due to staff shortages. Although we found no harm occurring, there was a risk to people.

The record keeping of staff training was out of date. When this was raised with the registered manager, assurances were given that the system had not been updated correctly. Staff feedback in relation to training was mixed. One staff member said, “I had my induction, but nothing since.” Another added, “We have lots of training available online, it is just finding the time to do it.” Staff spoken with did display a good knowledge of essential training such as safeguarding, first aid and manual handling.

Spot checks were documented in staff files. However, these lacked meaningful details and were similar from month to month. Staff we spoke with told us they had checks, but these were not that regular. They also reported that although they did feel supported when needed, robust supervision was not regularly provided.

The registered manager was receptive to our feedback and has provided details of how these matters will be improved following the inspection .

The provider had an effective recruitment process which was followed robustly.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff followed guidelines for infection control to keep people safe and healthy. People reported that staff wore personal protective equipment (PPE) appropriately during their care calls.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Those people who were supported with their medicines told us that this was done safely. Monthly audits of medicines were undertaken and any concerns or issues addressed quickly. Staff who supported with medicines had received appropriate training.