Archived: Laurel Bank Support at Home

Updated 19 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 checked 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.

The inspection took place on 25 January, 1 and 17 February 2017 and was announced.. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that the office would be open and manned.

Prior to the inspection we spoke with the local authority commissioners and reviewed the Provider Information Return (PIR) which had been submitted by the service in September 2016. The information provided by the commissioning authority in the form of a contract monitoring visit report showed they had identified concerns about the running of the service and the quality and safety of the provision and had asked that action be taken.

The inspection was carried out by one adult social care inspector on the 25 January and 1 February and the Inspection Manager on the 17 February 2017. During the inspection we spoke with the registered provider, manager, the general manager, two care coordinators and four members of care staff. We spoke with six people who used the service via telephone to gather their views of the service. We reviewed the care records for five people who currently received support, the recruitment files for three staff, policies and procedures, complaints and compliment records, audits that had been carried out on daily records and medication administration records (MARs), quality assurance questionnaires and staff rotas.

Updated 19 April 2017

The inspection took place on 25 January and 1 February 2017 and was announced on both days. The service was last inspected June 2015 at which time they were found to be in breach of Regulations 12 safe care and treatment, Regulation 17 Good governance and Regulation 18 staffing. We found the registered provider had not made the required improvements and there were continued breaches of Regulations 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found there were additional breaches in regulations 9 person centred care, 11 Need for consent, 13 Safeguarding service users from abuse and improper treatment and regulation 19 fit and proper persons employed. This showed there had been a decline in the quality and safety of the service since our last inspection.

Laurel Bank Support at Home is a domiciliary care service offering care to people in their own homes. The service covers areas in both Tameside and Stockport and was offering support to approximately 104 service users at the time of the inspection.

There was no registered manager at the time of the inspection. There was a manager in post on the first day of the inspection; however they had left the service by the second day. 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.

Staff had undertaken mandatory training; however they were unable to demonstrate their knowledge and understanding of subjects including safeguarding vulnerable people from harm.

Risk assessments were not always in place and where they were they did not reflect the specific risk or the measures needed to minimise the risk.

Staff recruitment processes were not always in line with the organisations policy.

Medicines were not managed safely and there were poor standards of care for specific conditions including diabetes.

Staff were not well trained and supported to carry out their roles effectively.

The service was not working within the Mental Capacity Act 2005, and was not gaining consent from people for the care they received.

Whilst staff were kind and committed, they lacked understanding in relation to treating people with dignity and respect. Staff also confirmed they sometimes overstepped the boundaries of a professional carer.

Care plans were not person-centred and did not reflect the needs of people who used the service. There was little evidence that care plans were reviewed.

There was no leadership in the service, which had been without a registered manager for a period of 480 days. There was no oversight or monitoring of the quality and safety of the service by the senior manager or registered provider.

The service was found to be in breach of seven regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.