Archived: Symons House

Updated 4 March 2016

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.

The inspection took place on 13 January 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure there would be someone in the office.

The inspection was carried out by one adult social care inspector and an expert by experience who has experience of caring for someone using this type of service. Their expertise was in the care of older people and they spent time speaking with people who used the service. Before the inspection we reviewed the information we held about the service and contacted the local authority and Healthwatch. We used some information they sent when planning our inspection. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We sent a provider information form (PIR) to the service before the inspection; however we visited before this was completed. A PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We received this information after the inspection.

At the time of the inspection there were seven people using the service. We spoke on the phone with three relatives of people who used the service. In addition we spoke with six members of staff and the registered manager. We spent time looking at records relating to the care of people and the running of the service. We looked in detail at the care plans of four people.

Updated 4 March 2016

Our inspection took place on 13 January 2016 and was announced. We gave the provider 48 hours’ notice of our visit to make sure the manager or their representative would be available.

Symons House provides personal care to people in their own homes, and is known as E J Specialists by people using the service. At the time of our inspection there were seven people using the service. This was the first time the CQC had inspected Symons House.

There was a registered manager in post, and they were also the registered provider. 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.

People we spoke with gave inconsistent feedback about the safety of the service, although we found most staff had a good understanding of safeguarding of vulnerable adults and all understood their responsibilities to report any concerns about people. The provider had trained staff in safeguarding, and we found most staff were able to confidently describe the types of abuse which people who used the service may be at risk from. All staff understood their responsibilities in reporting any concerns to the registered manager or bodies such as the local authority and CQC.

We looked at recruitment records of three staff and saw the provider sought references from former employers and undertook background checks with the Disclosure and Barring Service (DBS) to ensure staff were not barred from working with vulnerable people. We looked at records relating to induction and spoke with the registered manager and staff about the process. We found appropriate training was given, including shadowing of experienced staff before working unsupervised.

Staff we spoke with said they had time to travel between their calls, but people who used the service said they often found calls were not on time. We saw how the provider had put systems in place to improve their delivery in this area.

We saw people’s care plans contained risk assessments which showed the provider understood how to identify individual risk to ensure people were safe. Care plans contained clear information about how any risks could be mitigated. Systems and processes were in place to ensure safe management of medicines. We saw the provider checked records relating to medication to ensure people who used the service were supported safely with their medicines.

Staff we spoke with told us they felt supported and had regular supervision from the registered manager. They told us they had individual appointments to meet with the registered manager for these discussions. We found supervisions were not documented and were not taking place at the frequency described in the provider’s policy.

We found evidence training was carried out but did not see a robust plan to ensure mandatory training was refreshed regularly. We saw the provider spot checked staff to assess care and support delivery but there was no plan which showed how often or when this would be done. The provider sent us an updated training matrix after the inspection.

Care plans contained detailed mental capacity assessments and showed who would support people to make decisions when they were unable to do this for themselves.

People told us the staff were caring, and staff could tell us about how they worked to protect the privacy and dignity of people who used the service.

We saw evidence people who used the service and their relatives were involved in care planning and had opportunity to give feedback about the care and support they received. Care plans contained detailed, person centred information.

We saw there was a process in place to manage complaints and concerns but found it was not being followed in resolving issues raised.

People we spoke with were not confident the service was well-led. The registered manager discussed with us during the inspection how they would access more support. Quality assurance systems were informal and did not evidence meaningful oversight of the service delivery. The registered manager did not collate or analyse information to enable them to identify any emerging trends and take timely appropriate action.

Staff we spoke with gave more positive feedback about the registered manager and leadership in the service. They said they had opportunity to attend meetings and told us they felt able to speak freely; however, we could not determine the frequency of the meetings.

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