27 November, 2 and 7 December 2015
During a routine inspection
This inspection was unannounced and took place on the 27 November and the 2 and 7 December 2015.
Pegasus Care Limited provides personal care and support to older people who need care in their own homes. The service is run from an office in Chesterfield and provides care to people in North Derbyshire. We carried out this inspection at the provider’s office on 27 November 2015. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to make sure the manager was available. There were 77 people receiving personal care in their own homes from Pegasus Care Limited. We visited and spoke with five people in their own homes and also four of their relatives on 2 December 2015. We also spoke with three people and two relatives by telephone on 7 December 2015.
There is a registered manager at this service. 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.
At our last inspection in November 2013 people were not fully protected from risks associated with unsafe medicines practices. This was because the provider had not always ensured the safe administration and recording of people’s medicines. People were also not fully protected from receiving inappropriate care. This was because the provider’s records did not always show whether the Mental Capacity Act (MCA) 2005 had been followed to obtain people’s consent or appropriate authorisation for their care. These were respective breaches of Regulations 13 and 18 of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2010, which correspond with regulations 12 and 11 of the of the HSCA 2008 (Regulated Activities) Regulations 2014. Following that inspection, the provider told us what action they were going to take to rectify the breaches and at this inspection we found that improvements were made.
People received safe care and support and the provider’s arrangements helped to protect people from the risk of harm and abuse. Known risks to people’s safety associated with their care, medicines and support needs were safely managed.
Staff understood their roles and responsibilities for people’s care and safety needs and for reporting any related concerns. The provider’s arrangements for staff training and their operational procedures supported this.
The provider’s management arrangements for staff recruitment and deployment helped to make sure that staff were fit to work at the service and provide peoples’ care.
Staff understood and followed the MCA, to obtain people’s consent for their care or determine care to be provided in their best interests. The provider’s training arrangements and policy guidance supported this. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to make particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
Staff understood people’s personal care needs and associated health conditions. People’s planned care was shared with them, recorded when given and regularly reviewed to check its effectiveness.
People received appropriate support to manage their meals and nutrition when required. This was done in a way that met with their needs and choices
People were satisfied with their care and they were appropriately informed and involved in planning and agreeing this.
People received the care they needed from staff who were kind and caring and consistently trained and supported to perform their roles and responsibilities.
The provider’s management arrangements helped to inform and determine service improvements and staff development and training needs.
Staff considered people’s needs and wishes and they supported people in a personalised way. Staff demonstrated they understood the provider’s aims and values, which helped to ensure people’s rights and involvement in their care.
The provider regularly sought and listened to people’s views about their care. People knew how and were confident to make a complaint if they needed to.
The provider’s arrangements helped to ensure that learning took place from people’s concerns, comments and complaints and used to improve people’s care experience.
The service was well managed and staff understood their roles and responsibilities for people’s care and their expected conduct in this. The provider’s operational measures helped to promote this and determined clear arrangements for the management and day to day running of the service.
Regular checks were made of the quality and safety of people’s care, which helped to inform and plan service improvements.