Archived: Tynedale Care - Unit 1 Burnhaugh Estate

Updated 12 April 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 16 February and 3 and 6 March 2017 and was announced. The provider was given 48 hours' notice because the location provides care services within people’s homes and we needed to be sure that people would be aware that an inspection was taking place in the event we contacted them and also to be assured staff were available at the providers offices. The inspection was carried out by one inspector and one inspection manager who completed a yearly competency check on the inspector. There was also one expert by experience part of the inspection team. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We reviewed information we held about the service, including the notifications we had received from the provider about serious injuries or safeguarding concerns. Prior to the inspection we contacted the local authority contracts teams and safeguarding officers. We also contacted the local Healthwatch organisation by email to obtain their opinion of the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. None of the stakeholders who responded raised any concerns.

We contacted health and social care professionals by telephone before and following the inspection to seek their opinion of the service. These included community nurses, social workers, care managers from the local authority, occupational therapists and speech and language therapists. We used any responses to support our judgement.

We spoke with 12 people who used the service and three of their relatives or friends.

We contacted six care staff by telephone during the inspection. We also spoke with the registered manager, two directors of the organisation (one of whom was the nominated individual), the area manager, the infrastructure manager, one scheduler, the medicines coordinator and two office administrators.

We looked at a range of eight care records which included medicine records and the related IT recordings. We also checked the personnel records of six staff members. We looked at accident and incident records, training records, quality assurance checks, health and safety information, risk assessments, meeting minutes and previous surveys undertaken.

Updated 12 April 2017

We last inspected this service in May and June 2016 where we found the provider was not meeting Regulations 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 which related to good governance and staffing. The provider had no system in place to analyse accidents or ensure that suitable actions had been taken when accidents had occurred. There was not enough staff deployed and staff had not received suitable support and training to meet people’s identified needs.

We asked the provider to send us an action plan to tell us how they would address these concerns and we returned to check the service was now meeting all of the regulations. This announced inspection took place on 16 February and 3 and 6 March 2017.

We confirmed the provider had made improvements to the issues we had raised but we considered further measures were required in other areas of governance.

At the time of our inspection Tynedale Care - Unit 1 Burnhaugh Estate provided home care and housing support (including shopping and sitting services) across Northumberland to 140 adults living in their own homes and meant staff covered over 1900 care and support hours per week to help these people. These figures will fluctuate due to the nature of the service.

The service had a registered manager in post. 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 safeguarding policies and procedures in place. Staff knew what actions they would take if abuse was suspected. The provider had dealt with any previous safeguarding concerns appropriately.

The provider had invested in a new medicines management system to the majority of people who used the service. This included the introduction of an electronic recording system for staff to use when administering people with their medicines and was seen as an improvement on the previous paper records used. People told us that staff managed their medicines well and they received them on time. Staff supported people to store and dispose of medicines safely.

Accidents and incidents were recorded and dealt with effectively by the provider. Where issues (including complaints) had occurred, actions had been taken and lessons learnt. Risks were identified and assessed to ensure people and the staff who supported them remained as safe as possible.

Staffing levels were maintained by timely and safe recruitment procedures. The provider had a system in place to ensure rota allocations were monitored so people received their care ‘call’ on time and staff were kept safe. The registered manager told us they tried to ensure people were visited by the same care staff but that was not always possible due to sickness or holidays. Since the last inspection the provider had reduced the number of people they supported to ensure they had enough staff to support people fully.

Staff received an induction in line with the Care Certificate and completed appropriate training. The provider had spent time checking to ensure that all staff had received what they perceived as their own mandatory training programme and any additional training they thought was required. Staff told us they felt supported and had been provided with adequate supervision and had received annual appraisals, although we have made a recommendation about this.

The registered manager was fully aware of the Mental Capacity Act 2005, particularly in relation to the court of protection and lasting power of attorney. There were policies and procedures in place and staff had been trained. We saw one person had previously required the support of an advocate and the provider had supported this process.

Some people received support with eating and drinking as part of their care package and they told us staff supported them effectively. People were provided with meals they had chosen and preferred, and staff ensured drinks were left between visits for people if they required them. We saw that where people’s nutrition and hydration was closely observed, that staff had completed monitoring charts to ensure correct levels were maintained.

Staff promoted people’s independence and treated people with warmth and kindness in a respectful and dignified manner. People’s likes and dislikes had been recorded and staff, including office staff, knew the people they supported. Care plans and associated documents were tailored around the individual and involved them, their family and professionals as necessary.

Yearly surveys were undertaken and we saw that this was due to take place in the near future.

There was a complaints procedure in place and people and their relatives told us they knew how to access it and said they would have no hesitation to use it should they need to.

People were supported to ensure they were not socially isolated, which included staff chatting with them during visits. Where activities were part of people's care package, staff supported them with activities they chose and enjoyed doing.

People knew how to complain and told us they would if they needed to with no hesitation.

The service had a dedicated registered manager in place, who was committed to providing a good service. The provider was open to improvements which could be made and had invested in new technologies to enhance the running of the service.

The provider told us they monitored missed calls and medication errors but we found this was not always easily evidenced and needed to be improved. We have made a recommendation.