Archived: Positive Community Care Limited

Updated 5 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on the 4, 5 and 7 December 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because we needed to make sure the Chief Executive Officer (CEO) and the area manager would be in the office to meet with us. One inspector carried out the inspection.

The site visit took place on 4 December 2018 when we visited the provider’s offices to speak with the management team and to review care records and policies and procedures. It ended on the 7 December when we fed back our findings to the CEO and the area manager. Our inspection included a visit to two supported living settings on the 5 December 2018.

Prior to our inspection we reviewed previous inspection reports and notifications we had received from the service. A notification is information about important events that the provider is required to send us by law. We took note of a quality alert shared by one local authority and we spoke with two commissioning authority.

During our inspection, we looked at five people's care records. This included their care plans, risk assessments and daily notes. We reviewed five people’s medicine administration records. We observed and listened to staff interactions with people in the supported living services throughout the second day. We reviewed three staff personnel files. This included their recruitment, training, and supervision records.

During the inspection we spoke with four people who used the service, the CEO, the area manager, three team leaders, one senior support worker and three care workers.

Updated 5 February 2019

This announced inspection took place on the 4, 6 and 7 December 2018.

Positive Community Care Limited is registered to provide two registered activities from the same location. At the last inspection on 27 June 2017 we inspected the regulated activity of accommodation for persons who require nursing or personal care and rated the service good in all key questions. At this visit we inspected the second regulated activity of personal care in Positive Community Care Limited domiciliary care agency. The service in relation to personal care relates to people living in their own houses and flats in the community and specialist housing. The service is for older people who may be living with dementia and younger people with mental health and/or other disabilities.

This personal care service provided care and support to people living in 18 supported living settings so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support. The supported living settings were situated across five local authorities.

Not everyone using Positive Community Care limited receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection a service was being offered to 73 people however, only 5 of those people were being offered the regulated activity of personal care.

The registered manager had left the service in September 2018. 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. The provider had recently recruited an area manager who was intending to register with the CQC.

Whilst staff were offered an induction and shadowed experienced staff they were not always being supported to complete their training in a timely manner. Therefore, we could not be assured people living in some of the services were being supported by staff equipped with all the necessary knowledge and skills.

Although there was evidence of robust risk assessment in more established settings we found in a ‘newer’ setting that the risks to people had not been thoroughly identified and therefore measures to keep people safe were not in place and accessible for staff reference.

The provider was not always working in line with the Mental Capacity Act 2005 as they had not always taken the necessary steps to ascertain people’s capacity about their finances and had not ensured relatives managing their money had the legal right to do so.

The provider had systems in place to audit the medicines, incidents and accidents, safeguarding alerts and complaints. However, the above concerns had not identified and addressed in a timely manner.

People told us staff were friendly and caring. In almost all instances staff interactions with people observed and heard were positive and kind. People said staff respected their privacy and people were supported to be as independent as possible to uphold their self-respect.

Staff supported people to undertake a variety of activities at home and in the community. People’s diversity support needs were identified and they were supported in their cultural observances.

The provider assessed people’s needs prior to offering a placement and people had person centred care plans that informed staff how they wanted to be supported.

Staff administered medicines in a safe way and people were supported to access appropriate health care for both their physical and mental health. People told us they liked the food provided and that they were given their choice of meals. Heathy eating was promoted in the services and people who had dietary care needs were being appropriately supported by staff.

The provider assessed staffing needs in the services and ensured staff were recruited using safe recruitment processes.

Staff told us how they would recognise signs of abuse and told us how they would report safeguarding adult concerns appropriately.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Staffing and Good governance.

You can see what action we told the provider to take at the back of the full version of the report.