All inspections: Select Care - Care Quality Commission

This announced inspection took place on the 25 and 27 April 2017. Select Care provides personal care to people who live in their own homes in the community. At the time of our inspection the service was supporting 36 people.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were systems in place to monitor the quality of the service provided, however records were not always kept up to date and important information relating to communication with health professionals and relatives were not recorded.

People had care plans that were personalised to their individual needs and wishes. Records contained detailed information to assist care workers to provide care and support in an individualised manner that respected each person's individual requirements and promoted treating people with dignity.

Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe but also enabled positive risk taking. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

People told us that they felt cared for safely in their own home. Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. Staff understood their role in caring for people with limited or no capacity under the Mental Capacity Act 2005.

Staffing levels ensured that people received the support they required safely and at the times they needed. The recruitment practice protected people from being cared for by staff that were unsuitable to work in their home.

People received care from staff that were compassionate, friendly and kind and who would go the extra mile to support people and their families. Staff had the skills and knowledge to provide the care and support people needed and were supported the registered manager who was receptive to ideas and committed to providing a high standard of care.

This inspection took place on the 25 and 26 May 2016 and was announced. Select Care is a domiciliary care service that supports people with personal care over the age of 65 living in their own homes. At the time of our inspection 43 people were receiving care and support.

There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were not always protected against the risks of avoidable harm and abuse. Some staff and the registered manager were not aware of their responsibilities with regards to safeguarding people who were at risk of self neglect.

The systems in place for monitoring the quality of the service delivery were not always used effectively. Although there were systems in place to monitor the quality of the care provided, there was no evidence that the findings from the audit checks, satisfaction surveys or spot check supervisions was recorded or actioned.

We saw that the service was not working within the principles of the Mental Capacity Act (MCA). The registered manager and staff were not always aware of their responsibilities under the MCA Code of Practice.

Care plans only detailed people’s basic care needs and although care plans were reviewed on a regular basis, they didn’t always reflect people’s current care and support needs.

The registered manager did not keep up to date with new legislation, ways of improving care delivery and technology to support people.

People told us that they felt safe in their own home and we observed people to be happy and relaxed around the staff that supported them. All staff had completed the provider’s mandatory training. Staffing levels ensured that people received the support they required at the times they needed. We observed that there was sufficient staff to meet the needs of the people they were supporting. The recruitment procedure protected people from being cared for by staff that were unsuitable to work in their home.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

Staff had good relationships with the people they supported. Complaints were appropriately investigated and action was taken to make improvements to the service when this was found to be necessary.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

During our inspection in March 2015, we found that the systems and processes in place for the recording of medicines were not always adequate or in line with expected best practice. This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds to regulation 12 (g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Following the inspection the provider sent us an action plan detailing the improvements they were going to make, and stating that improvements would be achieved by 22 June 2015.

This report only covers our findings in relation to the outstanding breach of regulation. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Select Care’ on our website at www.cqc.org.uk.

This inspection was announced and took place on 13 July 2015.

During this inspection, we found that improvements had been made to the systems in place within the service, to ensure that appropriate standards of medication administration and recording now took place.

While improvements had been made we have not revised the rating for this key question; to improve the rating to ‘Good’ would require a longer term track record of consistent good practice. We will review our rating for safe at the next comprehensive inspection.

Select Care is a domiciliary care agency providing personal care and social care support to people in their own homes. At the time of our inspection the service provided approximately 34 packages of personal care and support.

The inspection took place on 18 and 23 March 2015.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe whilst staff were delivering care in their home. Staff were knowledgeable about the risks of abuse and there were systems in place for recording, reporting and investigating incidents.

Risks to people’s safety had been assessed and staff used these to assist people to remain as independent as possible.

Staff numbers were based upon the amount of care that people required, in conjunction with their assessed dependency levels.

Standard recruitment policies and procedures were followed and staff had induction training before they commenced work independently.

Systems and processes in place for the recording of medicines were not adequate or in line with expected best practice.

Staff attended a variety of training to keep their knowledge and skills up to date. They received on-going support, from the registered manager.

Staff knew how to protect people who were unable to make decisions for themselves. There were policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards.

People’s nutritional needs had been assessed and they were satisfied with the support they received with their meals and drinks.

People’s physical health was monitored including health conditions and symptoms, so that appropriate referrals to health professionals could be made.

People had good relationships with staff and were happy with the support they received from them.

Staff enabled people to make choices about their care and daily lives and understood how to respect their privacy and dignity.

People were involved in developing their plan of care and had their own copy. Staff recorded their actions appropriately within the records.

The service had an effective complaints procedure in place. Staff were responsive to people’s concerns and when issues were raised these were acted upon promptly.

The provider did not have effective systems in place to monitor the quality and safety of the service.

We found the service was in breach of one of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

We spoke with three people who used the service and one relative of someone who used the service. They confirmed that they are visited by staff who are familiar with their needs and preferences. People also told us that they were happy with the care received. One person told us 'they are very good, all very cheerful and willing to help. They never let me down'. A relative told us 'I cannot fault them. They always come within five minutes of the time. I would recommend them to others.'

We looked at assessments and care plans for four people and saw that they contained information about people's needs and how staff should assist them. We saw that assessments and care plans for two of the four people had no record to show that they had been reviewed or evaluated in the last twelve months. This meant that staff may not have up to date information about people's care needs.

The provider explained that she was due to send out satisfaction surveys to people who used the service. We saw that none had been sent out for over 12 months. The provider explained that she sought feedback from people in person when she visited them but had not formally requested feedback since the last satisfaction surveys were issued. She told us that she visited each person who received a service approximately once a week and that as people know her they would also telephone her with any queries or concerns.

As part of the inspection we spoke with three people who used the service. They were very positive about the service they had received. One person told us, 'I'm quite happy with everything, in fact I look forward to them coming.' Another person told us, 'I have no complaints, I couldn't wish for better.'

We spoke with three relatives of people who were receiving care from the agency but for various reasons could not speak to us themselves. One relative said, 'We have used a number of care agencies over the years and have never had a care service like this, they are the best. If you ever need care for yourself this is the agency to choose.'

Another relative told us, 'My mother is very happy, they are friendly and flexible service.'

People told us they were happy with their care, one person said 'I'm very happy, they are great. They vary who you get, so you get to see everyone.'

We asked another person if they were happy with the care they received they said 'Yes, very much so.' One person who had been receiving care for over a decade said 'We could not be happier, nothing matches Select Care they are excellent.'

Archived: Select Care

All Inspections

25 April 2017

During a routine inspection

25 May 2016

During a routine inspection

13 July 2015

During an inspection looking at part of the service

18 and 23 March 2015

During a routine inspection

12 February 2014

During a routine inspection

17 October 2012

During a routine inspection

5 December 2011

During a routine inspection