4 and 9 December 2014
During a routine inspection
As the result of concerns raised by the local authority and by people contacting the Care Quality Commission we undertook an announced inspection of Sevacare - Sheffield on the 4 December 2014 and the 9 December 2014. We told the provider two days before our visit that we would be coming so that we were able to access the office and records of the service.
Staff from Sevacare - Sheffield provide personal care services to people in their own homes. At the time of our inspection 174 people were receiving a personal care service.
This was first time the service has been inspected by the Care Quality Commission. The service was registered with the Care Quality Commission on the 4 February 2014.
The registered manager for this service was not based at the service. We contacted the registered manager by telephone and they informed us they did not have any involvement in the management of the service. They were not present during the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
One of the provider’s supporting managers was managing the service at the time of the inspection. They informed us that a new manager had been recruited for the service and was due to start working at the service at the beginning of January 2015.
Out of the thirty three people spoken with, nine people were fully satisfied with the service being provided by Sevacare - Sheffield. People made very positive comments about staff and the care they received if they had regular care workers providing all or some of their care. However, people told us they want regular call times and regular care workers who were properly trained. We found the service had not made sure there were sufficient staff with the right knowledge and experience to support people to an appropriate standard.
Most people told us they felt “safe”. A few people told us they didn’t feel safe being supported by strangers and/or inexperienced staff who need more training. Most of the relatives spoken with felt their family member was safe but also expressed concerns about the training new staff had received.
Staff had received training in safeguarding vulnerable adults as part of their induction training. Our discussions with staff told us they were aware of how to raise any safeguarding concerns. However, we found some staff did not demonstrate a good understanding of the provider’s whistleblowing procedures.
The service did not have appropriate arrangements in place to manage medicines to ensure people were protected from the risks associated with medicines.
The service had not completed regular care plan reviews with people using the service. Individual risk assessments were completed for people so that identifiable risks were managed but these were not being regularly reviewed to ensure they reflecting people’s changing needs.
Some people’s nutritional and hydration needs were not being met because they were not experiencing regular calls during the day. This meant they were not being supported to have regular drinks and meals during the day.
Staff were able to demonstrate an understanding of the Mental Capacity Act 2005 (MCA). Staff were able to describe how they respected people’s privacy and treated people with dignity and respect. We received mixed views about the staff. Some people made very positive comments about the staff and described them as caring and that they were treated with dignity and respect. However, some people felt they were not treated with consideration and respect by staff.
Robust recruitment procedures were in place and appropriate checks were undertaken before staff started work. However, a few people expressed concerns regarding the standard of English of a few staff recruited from the European Union.
Staff received induction training for their roles. However, people and relatives were concerned that new staff had not been properly trained to enable them to deliver care to an appropriate standard. We found that staff competency had not been checked prior to them supporting people on their own to ensure people’s needs were met by competent staff. Staff had not received regular supervisions which meant their performance was not formally monitored and areas for improvement may not have been identified. This meant the service did not ensure staff received appropriate training, professional development, supervision and appraisal.
The provider had a complaint’s process in place. However, the provider did not have an effective system in place for identifying, receiving, handling and responding appropriately to complaints and comments made by people or persons acting on their behalf.
The provider had not ensured there were effective systems in place to monitor and improve the quality of the service provided. This meant they were not meeting the requirements to protect people from the risk and unsafe care by effectively assessing and monitoring the service being provided.
We found seven breaches 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.