Background to this inspection
Updated
8 September 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.
This inspection was undertaken on the 14 of December 2014 and was unannounced.
The inspection team consisted of two adult social care inspectors. We received information from Social Services, people using the service, their families, staff and the Police regarding concerning information in relation to medicines management, staff not attending visits to people in their own homes, lack of training for staff and not managing risks for people.
The inspectors visited the main office of the agency on the 14 December 2014 and reviewed six peoples care records and records in relation to the management of the service. We requested contact details of relatives, staff and people using the service. Following the inspection the inspectors contacted fourteen relatives and six staff for their views.
Updated
8 September 2016
This inspection was a follow up inspection where breaches had been identified and in response to concerns received. At this inspection the service was providing care and support for 52 people living in their own homes. The provider had two other locations also providing care in people’s own homes at Lancaster and Nelson. The service provided care and support for older persons , dementia care, end of life care, long term conditions, respite care and night care.
There was a registered manager in post. 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 and associated Regulations about how the service is run.
People and staff gave a mixed view about the service. Overall relatives appreciated individual staff but told us that the service was not well managed and their relatives were not always safely cared for. Some staff thought they were well supported I their role whilst others told is they had not received sufficient training, instructions as to care for people or support in their role .
There were safeguarding policies and procedures in place. However these were not being implemented and safeguarding concerns were not recognised or addressed. The service was requested to make five safeguarding concerns with the Local Authority that were identified at the inspection but had previously not be recognised by the service. Safeguarding concerns were not always notified to CQC as required.
We checked medicines management. We found that clear and accurate records were not being kept of medicines administered by care workers. Care plans and risk assessments did not support the safe handling of some people’s medicines. The service had failed to recognise and address risks to people they were supporting placing them at risk of harm. Were incidents had occurred no action had been taken to prevent these from reoccurring.
We checked how the service followed the principles of the Mental Capacity Act 2005 (MCA)
The MCA governs decision-making on behalf of adults who may not be able to make particular decisions. The requirements of the MCA were not being followed.
There were no systems in place to monitor any aspects of the quality of the service or to improve failing areas. Issue identified at previous inspections had not been addressed. As a result people were at risk of not having their health and welfare needs met.
Overall we found significant concerns as how the service was meeting the regulations. We are considering what further actions may be required and we will report on any actions once completed.