Care-D/UK

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. The provider told us 14 people were supported with personal care.

Whilst people received an assessment of their needs and preferences when they joined the service, it was not demonstrated how people's need were consistently met following frequent late, missed and shortened visits. People gave mixed feedback about care workers. Whilst some were described as kind and caring, this was inconsistent. The provider did not schedule visits in a way that always enabled staff to provide a caring service. People described being rushed, having to rely on family and friends, or trying to carry out their own care unsupported when staff did not arrive.

Care plans were in place and being reviewed. However, records were not always completed, which meant changes to people's care needs might be missed. The provider logged and responded to complaints. However, there was no effective action to address the main underlying cause of complaints which were late, missed and shortened calls.

Systems and processes for governance, oversight and improvement were not comprehensively established or embedded. Actions the provider told us had been taken since the last CQC inspection had not all been implemented effectively. Audits did not always identify concerns or show the action to take as a result. Mechanisms for engaging with people and seeking feedback about the quality of the service were not effective.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Staff received training to support them in their role, including for specific health needs such as diabetes and

epilepsy. Staff received 'spot check' supervisions whilst carrying out visits. The provider worked with other health and social care professionals. Staff could explain the steps they should take to support a person's privacy and dignity. A policy was in place for meeting the Accessible Information Standard and for end of life care. Most staff told us they felt supported by management.