Preston care provider “requires improvement” as breaches in relation to safe care, treatment and good governance are found

Direct Approach Care Limited, located on Marsh Lane, provides support with personal care to people living in their own homes, including those with dementia and mental health conditions, and was inspected for the first time on May 16 this year.

Although rated good for being ‘effective’ and ‘caring’, inspectors said the service “requires improvement” for the categories safe, responsive and well-led.

Stating that “the service was not always safe”, the report explained that although there was no evidence that people had been harmed, systems and processes were not consistently implemented to ensure risks were assessed, monitored and mitigated, nor were systems in place robust enough to provide assurances about safe medicines management.

It read: “Information about people's risks was not comprehensive enough. There was no evidence that the service looked for safety related themes or trends. We could not be assured that medicines were always managed safely as audit processes were not in place.”

The inspectors also said that “recruitment processes were not robust enough to ensure staff were safe to work with people”, for instance full employment histories were not always recorded or corroborated.

Meanwhile the servies’s safeguarding policy did not reflect current guidance, with the CQC issuing recommendations that Direct Approach Care update its policies.

The inspectors also found that the service was not always responsive, with people's care plans not containing enough information about their routines and preferences, nor was it always well-led, as “systems for governance and performance management either did not exist or were not reliable or effective”.

Despite pointing out breaches, the report added: “The registered manager began to address our concerns immediately following the inspection, showing they were responsive and committed to making the required improvements, and that the safety and quality of the service was a priority.”

Direct Approach Care was praised for being caring, with service users and their relatives telling inspectors that staff treated them well.

The reported added: “People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.”

The CQC will continue to monitor information they receive about Direct Approach Care, which will help inform when they next inspect.

Direct Approach Care’s registered manager, Carlie Brooks said: “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 and disabilities.

“Due to covid, I was on shift most days as staff was off sick or had to isolate due to family settings.

“The staff hired in the office and at a senior level was not carrying out their duties and not completing their roles which resulted in termination of employment.

“Some auditing was 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 was 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 safeguarding concerns.

“I requested a CQC inspection two years prior as I wanted to know all was going correctly but covid pandemic unfortunately stopped the process.

“We are now up to to date with our requirements and looked forward to our next inspection.”