Archived: Style Healthcare

The service was previously inspected in September 2014 when breaches of legal requirements were found. At that inspection we found the service was not meeting three of the essential standards and regulations that we assessed. We found that people were not fully protected against the risk of receiving inappropriate or unsafe care by means of carrying out an assessment of needs and planning care to meet people’s individual needs. We also found the provider did not have effective recruitment procedures in place and the provider did not have effective systems in place to identify, assess and manage risk relating to health, welfare and safety. Following this inspection the provider sent us an action plan to tell us the improvements they were going to make. During this inspection we found that some improvements had been made.

When we visited the service there was a registered manager in post although they were not present during this 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.

Style Healthcare is registered to provide personal care and support to people living in their own home. At the time of our inspection there were 17 people using the service.

During this inspection we identified six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to staff training, staff recruitment, staff supervision, care plans lacking detail, medicine management and the lack of systems to assess and monitor the service delivered to people; you can see what action we told the provider to take at the back of the full version of this report.

From looking at the training records, speaking with the office manager and staff we found there were gaps in staff training. This meant some staff may not be appropriately trained and skilled to meet the needs of the people receiving a service.

Recruitment processes still required improvements to ensure only suitable staff were employed.

Care plans in relation to medication administration were vague and staff had not undertaken competency assessments on completion of medication training to ensure they were suitably skilled and competent in medication administration.

Not all staff were receiving regular supervision or annual appraisals.

Care plans looked at did not contain enough detailed information to direct staff members on how to provide care and support for people taking into account the person’s personal preferences and encouraging independence.

We recommended the service considers obtaining a copy of the Mental Capacity Act 2005 code of practice and in accordance with the MCA consent to a care plan is only signed for by a person who has the legal authority to do so.

Due to the shortfalls found during this inspection process the quality assurance processes need to be more robust.

We were told by relatives of people receiving a service and staff that there was a relaxed and friendly atmosphere between staff, people receiving a service and their relatives.

We were told by the person we spoke with who was receiving services and relatives we spoke with that staff were kind and respectful to people when attending to their needs.

People, who we asked, told us they felt safe and comfortable when being supported by the care staff.

Those staff we spoke with understood their responsibilities to protect the wellbeing of the people who used the service and were clear about the action they would take if an allegation of abuse was made to them or if they suspected that abuse had occurred.

People said they knew who to contact if they wanted to make a complaint and felt they would be listened to and action would be taken. However we recommended that all informal concerns/issues raised are formally recorded, investigated and proportionate action taken in response so that there is a clear system to review and learn from issues raised.

We considered the evidence collected under the outcomes and addressed the following questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?

Below is a summary of what we found. Please read the full report for the evidence supporting our summary.

Is the service safe?

The sample of care plan records we looked at did not show that the provider always carried out appropriate assessments or that appropriate care plans were in place. We saw that information available to staff about the needs of the people who used the service and how to deliver care was not always up to date or consistent.

We saw that there were systems in place to assist people with their medication and that care staff were trained to provide this assistance.

There were not appropriate systems in place to ensure that appropriate staff were recruited. The provider had not taken reasonable steps to ensure that staff members were of good character prior to their employment or working unsupervised with people who used the service.

Is the service effective?

The care staff we spoke with told us that the care plan records in people's homes provided them with enough information and direction to enable them to deliver appropriate care. The people we spoke with told us they had no concerns about the service their relative's received. One person commented 'we're happy with them, if we weren't we wouldn't have stayed with them for so long'.

We saw that where appropriate the service involved and worked with other professionals, such as medical professionals, to meet people's needs. The people we spoke with told us about how the service had worked with other professionals when required to make arrangements when people were discharged from hospital or where respite stays had been needed by people.

Is the service caring?

People we spoke with generally made positive comments about the service. People told us that their relative's felt safe with the staff who visited and that staff treated people kindly and with respect. One relative told us 'she sees them as friends, she enjoys their company'.

Is the service responsive?

We saw that there was 24 hour contact and advice from senior staff available by telephone for care staff and people who used the service. The staff we spoke with felt able to speak with senior staff when they needed to.

Is the service well led?

The provider did not have an effective system in place to identify shortfalls in the service it provided. The provider had not identified when people's care records were incomplete or required updating and had not identified that reasonable steps to ensure that staff that were recruited were of good character, had not been taken.

We looked at the policies and procedures in place to protect people from harm and abuse because we had concerns in this area at our last inspection. We found that the procedures had been updated and all the staff had received adequate training in safeguarding vulnerable people.

We looked at the support that staff received because we had concerns in this area at our last inspection. We looked at the systems in place currently and found that staff received adequate support which included regular supervision, a yearly appraisal and all mandatory training.

We looked at the quality assurance systems in place and saw that the service was carrying out sufficient checks to ensure that they were providing a good service.