Information we gained during our visit demonstrated that the provider needed to make improvements in relation to reporting allegations of abuse; the management of records relating to the service and the development of a management structure for the service.
When we visited in May and July 2013 we found that the provider needed to take action in ten outcome areas to become compliant with the Essential Standards of Quality and Safety.
The purpose of this visit was to establish what actions the provider had taken to ensure that people receive safe care and support. We found that some training had been provided to staff since our last visit and some of the policies and procedures had been reviewed. However, we found that improvements were needed to be made in relation to planning people's care, recruitment and support of staff, complaints management, safeguarding people, records management and the overall management of the service. The provider is failing to demonstrate that they can provide safe care and support to people who use the service.
During our previous visit in May 2013 we identified several areas of non -compliance. During this visit we found that further areas of non- compliance in relation to records and requirements relating to workers.
In this report the name of a registered manager appears who was not in post and not managing the regulated activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.
The purpose of this visit was to establish what actions the provider had taken to ensure that people receive safe care and support. We found that some training had been provided to staff since our last visit and a new medication administration record had been developed. However, we found that improvements needed to be made in relation to planning people's care, recruitment and support of staff, safeguarding people, records management and the overall management of the service. The provider is failing to demonstrate that they can provide safe care and support to people who use the service.
The purpose of this inspection was to establish what actions the provider had taken to ensure that people receive safe care and support.
As part of this inspection we spoke to the provider, the manager, three people who use the service and a relative and three members of staff.
People told us good things about the staff who visit them in their homes. Their comments included "feel comfortable"; "feel safe when they give me a bedbath" and "the biggest part of them are great." People told us that staff treated them with respect.
We found that imrpovements were needed to be made in relation to supporting the staff team; the recruitment of staff, care planning and safeguarding of people and to the overall management of the service which is failing to demonstrate that it can provide safe care.
We issued two warning notices to the provider in December 2012 in relation to the recruitment procedures for staff and records maintained within the service.
We visited the service on the 9 and 29 January 2013 to establish what action the provider had taken to improve their recruitment procedures and in maintaining records. We found that although some improvements had been made there were still outstanding issues in relation to recruitment processes and records and therefore the terms of the warning notices were not met.
During this visit on 21 February 2013 we saw that some improvements had been made in relation to appropriate checks being undertaken before staff began work. We looked at the recruitment files of all staff members. We saw that further information had been added to staff files to demonstrate their fitness for their role since our previous visits. However, we saw that a recruitment file for a senior member of staff contained no application form and only one reference.
Recruitment procedures and practices failed to demonstrate that the provider had made appropriate check to help ensure that only people suitable for their role were employed. Therefore the terms of the warning notices still remain unmet.
We issued two warning notices to the provider in December 2012 in relation to the recruitment procedures for staff and records within the service.We visited the service on the 9 and 29 January 2013.
The purpose of our visits on 9 and 29 January 2013 were to establish what action the provider had taken to improve their recruitment procedures and in maintaining records. Our findings from the visit were that there are still outstanding issues in relation to recruitment processes and records and therefore the terms of the warning notices were not met.
People we spoke with told us they were given choices as to what they needed care staff to do for them. They said that they were asked what they wanted and staff ensured people were provided with care of their choice.
People told us that the agency manager or senior care staff always asked them what they wanted and how the care should be provided. They said their individual needs were catered for.
Comments from people included "They call here everyday and do everything I want them to do", 'Staff are reliable and show a good understanding of our needs.'
One person told us that they felt at ease with agency staff and knew that they would look after them properly.
People we spoke with said they felt fully supported by the care staff. One person told us that the service was wonderful.
Comments from people included 'I used another care service before Makerfield. This service is much better, staff are kind and caring and come and go at the right times.'
'All nice girls.'
'Fantastic. Cracking bunch of girls. The owner is very bubbly, always brings a smile to my face when she walks through the door. They are always welcome.'
A relative told us:
'Mum has had the care for two months. They are great they do her food and whatever she needs. I can't fault it. Only the best.'
People told us that they felt safe.
People told us that the staff seem trained and know what they are doing.
People told us that the manager is very approachable.
People told us that they were involved in planning their care and had received a full assessment of their needs by the manager.
People told us that they had confidence in the staff and management. Should they wish to make a complaint they knew how to and felt they would be listened to.
People told us the staff always treated them with dignity and respect.
People told us the staff are always polite and arrive on time.
People told us that they have regular staff to provide continuity of care.
People told us that they are encouraged to manage their own medication if they are able to.
People told us that they feel safe.