Dignity Direct Homecare Limited

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

We identified a breach of regulations. The provider failed to provide safe effective leadership, governance and maintain robust oversight of the service and its delivery. Risks to people were not always assessed and care plans were not person centred with sufficient guidance for staff to follow. Staff recruitment was not robust. The provider failed to work within the principles of the MCA. There were systems and processes in place to manage and follow up on accidents and incidents. However, they were not effective to learn from or make f appropriate improvements. There were audits in place to monitor the quality of service. However, these were not robust enough to identify the issues we found during this assessment. We received a mixed feedback from people and their relatives in relation to the quality and management of the service. Staff described the leadership at the service as approachable and supportive. The branch manager told us they worked in partnership with external professionals as required, to achieve positive outcomes for people.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Staff described the leadership at the service as approachable and supportive. Staff meetings were held to discuss any changes in people’s needs and training. Communication records seen showed the branch manager and office staff team worked closely with commissioners and healthcare professionals.

At this assessment we found the provider did not have an effective system in place to assess, monitor and improve the quality and safety of the services being provided to people. Risks to people were not always assessed, recorded and managed in a safe manner. Care plans were not person centred with sufficient guidance for staff to deliver safe care. Systems in place for oversight of staff recruitment were not robust. Staff recruitment processes did not follow safe recruitment practices, and some staff were employed without prior police checks. The provider failed to work within the principles of the MCA and did not have the tools, skills, knowledge and systems in place to ensure consent to care and treatment was practiced in line with law and guidance. Staff were not always knowledgeable and understood their responsibilities. There were audits in place to monitor the quality of service. However, these were not robust enough to identify the issues found during this assessment. The provider was registered with the CQC to provide the regulated activity of personal care for Service User Bands: Dementia, Physical Disability, Sensory Impairment, and Whole population. Their registration did not cover service users with a learning disability (LD) and autism. Records reviewed showed the provider failed to notify CQC with an updated statement of purpose reflecting people with a learning disability and/ or autistic people to their service user bands, prior to providing personal care to people with LD and autism.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We saw the latest 3 staff meetings records and found the registered manager was not in attendance at these meetings. The registered manager was also not available during this assessment, we were told that they were on leave. Staff were not aware of any feedback about learning from incidents, accidents or concerns.

The provider maintained a complaints log which showed any concerns raised the branch manager investigated and responded to in a timely manner. There were systems and processes in place to manage and follow up on accidents and incidents. However, there was no analysis completed to identify any trends or patterns for lessons learnt and discussion with staff to minimise the risk of reoccurrence of such incidents and embed good practice within the service. There were instances where complete and contemporaneous records were not maintained. We found some care plans had been photocopied in their entirety and date had been tipexed over with new date, these contained the photocopied signatures of staff, people and their relatives. For example, one person’s care and risk assessments dated 2 December 2024, their front page was over written and the remaining 11 pages of the record was dated 2 December 2021, including the date and year was covered with a whitener. Another person’s care needs assessment and risk assessments dated 05/09/2023 has been photocopied and staff, person and their relatives and the date of assessment tipexed out with a new date of 19/07/24 written over. Notwithstanding the above, we found there were systems in place to ensure the provider sought the views of people using the service through spot checks of their care and people’s feedback survey that were conducted. People’s feedback from the 2023 survey has been positive.