CQC report explained · a residential care home
What the CQC found at Direct Approach Care Limited
Not yet rated: the CQC has not published a rated inspection for this home, which is usual for a new registration.
What inspectors found, June 2022
Rated Requires Improvement; inspectors found caring staff but gaps in risk management, medicines, care records and management systems.
This was the agency's first comprehensive inspection. Inspectors visited the office on 16 May 2022 and continued inspection activity until 25 May 2022. They reviewed three care plans, staff files, training records and quality checks. They also spoke with staff, one person using the service and three relatives.
The agency was rated Good for Effective and Caring. People and relatives said staff were kind, respectful and knew people's needs. Staff had training, supported people's choices and worked with health and social care professionals.
The agency was rated Requires Improvement for Safe, Responsive and Well-led. Risk information and care plans were incomplete. Medicines checks and recruitment records were not reliable. Complaints were not consistently recorded, and management systems did not identify or act on problems effectively.
The agency breached Regulation 12 on safe care and treatment and Regulation 17 on good governance. Inspectors found no evidence that anyone had been harmed. The registered manager began updating risk assessments, care plans and policies after the inspection, and CQC said it would monitor progress.
Kind and respectful staff
People and relatives were largely positive about the way staff treated them. Staff were described as caring, knowledgeable and patient.
“Staff are absolutely brilliant, knowledgeable and patient, they have changed [Name's] life.” from the report
Choice and consent
Inspectors were assured that staff sought consent and supported people in the least restrictive way possible.
“People were supported to have maximum choice and control of their lives” from the report
Staff training and support
Staff had completed required training and said they felt well supported by the manager and training programme.
“I have all the training I need and more” from the report
Support with community activities
The agency helped one person take part in activities linked to their interests. Inspectors said this helped the person build confidence and new relationships.
“The person gained in self-esteem and made new relationships within their local community.” from the report
Incomplete risk information
seriousCare plans did not always explain people's risks or how staff should manage them. Environmental risks in people's homes had also not been assessed.
“Risk was not consistently assessed and managed.” from the report
Medicines records and checks
seriousSome medicines administration records were missing or incomplete, and some doses had not been signed for correctly. There were no reliable checks to confirm medicines had been given safely.
“We could not be assured that staff had the required understanding of safe medicine administration.” from the report
Care plans lacked detail
needs fixingRecords did not always describe people's routines, preferences, mobility needs or end of life wishes. This created a risk that care would not match people's needs and wishes.
“Care records were basic, incomplete and did not always adequately document people's care and support needs” from the report
Weak management oversight
seriousAudits and quality checks were not consistently recorded or effective. The systems did not identify the problems found during the inspection.
“Governance processes and systems to monitor the safety and quality of the service were either not in place or effective enough to ensure reliable oversight of the service.” from the report
Complaints not recorded
needs fixingComplaints and responses were not consistently documented. It was therefore unclear how concerns were investigated or what learning was applied.
“We could not be assured complaints were managed consistently as complaints and any responses, were not recorded.” from the report
- 01What changes have been made to risk assessments for choking, behaviours that may challenge and hazards in people's homes?
- 02How are medicines administration records now checked, and how do you confirm medicines are given as prescribed?
- 03How have care plans been rewritten to record routines, preferences, mobility needs and end of life wishes?
- 04What audits are now completed, how often are they reviewed, and what happens when a problem is found?
- 05How are complaints and people's views recorded, investigated and used to improve the service?
This was the first comprehensive inspection of the domiciliary care agency, covering personal care for seven people at the time; inspection activity included an office visit, records, staff discussions and feedback from one person and three relatives. This explanation was written from the published report of 29 June 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Direct Approach Care Limited
Each visit the CQC has published, newest first, back to the day the home was registered.
- June 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at Direct Approach Care Limited →
- November 2020
Registered with the Care Quality Commission on 19 November 2020.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.