8 and 20 January 2015
During a routine inspection
This inspection took place over two days. The first visit was on 8 January 2015 and was unannounced. Another visit was made on 20 January 2015 on that day the provider knew we would return.
St Martha’s at Home is registered to provide personal care to people in their own homes. At the time of our inspection they were 76 people using the service.
We last inspected the service in January 2014. At that inspection we found the service was meeting all the regulations that we inspected.
No registered manager was in place at the time of our inspection. The manager advised us they had applied to become a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
The provider had not undertaken the necessary checks to ensure staff were suitable to work with vulnerable people. Staff we spoke to were not aware of safeguarding procedures and had not received any training on this subject.
People’s risk assessments were not regularly reviewed therefore we could not be sure they were an accurate reflection of people’s risk and needs.
We found care plans contained little personalised information about the person and their preferences. We saw care plans were not up to date and did not reflect a person’s current needs.
People told us they did not have any complaints about the service and all said they would contact the office if any arose.
Training records were not up to date and staff did not receive regular supervisions and appraisals, which meant that staff were not properly supported to provide care to people who used the service.
We were told by people using the service and their relatives that most of their health care appointments were arranged by themselves or their relatives. One service user told us, “If I’m poorly the girls get the Doctor for me and always look after me”.
People told us that care workers were caring and compassionate. One person said, “Staff are very caring.” Another told us, “My carer is excellent, we have a lovely relationship”.
People told us that they had very little communication from the staff in the office. Another commented, “I never get the same person to speak to when I ring the office; they have not been out to see me for a long time”.
Staff told us they gave people privacy whilst they undertook aspects of personal care, but ensured they were nearby to maintain the person’s safety, for example if they were at risk of falls.
The provider did not have effective quality assurance processes to monitor the quality and safety of the service provided and to ensure that people received appropriate care and support.
We found policies and procedures relating to the running of the service had not been reviewed and maintained to ensure that staff had access to up to date information and guidance.
The manager told us they had introduced a new memo system to improve the communication with staff.
During our inspection we identified five breaches of regulation. You can see what action we told the provider to take at the back of the full version of the report.