The Care Quality Commission (CQC), has rated Dresden Care Services Limited as inadequate and placed it into special measures to protect people following an inspection in February.
Dresden Care Services Limited, run by a company of the same name, is a domiciliary care agency that provides personal care to people in their own homes. The service supported seven people at the time of our inspection.
CQC found a breach related to management and oversight of the service at the previous inspection which remains in place. At this inspection, CQC found four further breaches of regulation around person-centred care, safe care and treatment, staffing and employing appropriate people. CQC issued the service with a warning notice to focus their attention on making rapid and widespread improvements in these areas.
The overall rating for the service, as well as the ratings for how safe, effective and well-led the service is, have dropped from requires improvement to inadequate. This inspection didn’t look at how caring and responsive the service is, which remain rated as good from their previous inspection.
The service has been placed in special measures, which means it will be kept under close review by CQC to keep people being supported safe while improvements are made.
CQC has also begun the process of taking regulatory action to address the concerns which Dresden Care Services has the right to appeal.
Amanda Lyndon, CQC deputy director of operations in the midlands, said:
“At our inspection, we were disappointed to find that leaders at Dresden Care Services hadn’t used the last report we gave them to make improvements, and in fact we found further deteriorations. We were particularly concerned that leaders hadn’t taken specific action around safety concerns and the effectiveness of people’s care which was putting people using the service at risk.
“While staff put people’s support plans in place, the plans lacked detail on health conditions and didn’t consider potential risks such as an unsafe home environment due to clutter.
“Staff also didn’t consider people’s individual needs when organising and delivering care, meaning it wasn’t person centred. The service supported some people with learning disabilities and autism, and although staff told us they were aware of best practice, they couldn’t demonstrate how this helped shape their support. Staff needed to develop care records to highlight how they were supporting people to live healthier lives, remain independent or where possible reduce their future needs for care and support.
“Leaders didn’t involve the people they cared for or their relatives in care planning or reviewing. This also extended to them not collating feedback and complaints or recording and investigating incidents to help identify potential improvements.
“We were disappointed to find the service still didn’t understand the importance of recognising and responding appropriately to safeguarding concerns. For example, one person had an epileptic seizure which was a known health condition to the service while in the bath. Staff failed to report this incident to the local authority’s safeguarding team because leaders didn’t provide appropriate guidance for them to follow.
“Dresden Care Services needed to work closer with partners to help provide safer care and a more seamless experience for people using the service. They didn’t provide relevant information and learning with partners. As a result, people received inconsistent care when moving between services.
“Our experience tells us that when a service isn’t well-led they are less likely to be able to provide good care which is what we found as Dresden Care Services.
We have told leaders where rapid and widespread improvements are urgently needed. We will continue to monitor the service closely to make sure people are kept safe.”
Inspectors found:
- Leaders didn’t have oversight of the service which negatively affected the quality of care provided.
- The service didn’t make sure there were enough qualified, skilled and experienced staff.
- Staff didn’t always assess people’s homes to make sure they were safe.
- The service didn’t review care plans or keep them up-to-date putting people at risk if their care needs changed for example.
- Leaders didn’t consistently match people with staff who understood their religious and cultural needs and could speak their language.
- The registered manager wasn’t always present and visible. Although relatives told us they could contact the service if they had a concern, they didn’t know who the registered manager was as they believed that the office administrator was the manager.
- Leaders didn’t make sure that the service focused on how they could improve people’s lives or protect their right to be free of bullying, harassment, abuse, discrimination, avoidable harm and neglect.
However:
- People told us that their requests to change a call time was accommodated.
The report will be published on CQC’s website in the coming days.