17 October 2016
During a routine inspection
There was not a registered manager in post. There was an acting manager who has been in post for three months who has submitted her application to become the registered manager.
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.
We found that recruitment procedures were not robust to ensure all the required information was obtained before staff commenced employment. This is required to ensure staff are suitable to work with people. Staff had received training and knew how to report and deal with issues regarding people’s safety.
People told us they did not always receive a reliable and consistent service, as some people had experienced late and missed calls. People told us they received their medicines as prescribed, but the medicine records were not always completed to demonstrate this. We found that people did not always have assessments in place to demonstrate how risks associated with providing their support had been assessed and managed to ensure people received a safe service.
Staff we spoke with understood that people have the right to refuse care and that they should not be unlawfully restricted. People received support from staff that were described as respectful and caring and ensured that people’s privacy and dignity was maintained. People were supported to maintain their health.
Care plans were not in place for all of the people that used the service. The information in the care records varied in quality and content and did not include detailed information about people’s needs and preferences for the staff to refer to.
People and their relatives did not always feel listened to and complaints were not always responded to in a timely manner. Information about people and staff was not kept confidential. The acting manager was aware of these issues and was taking action to address these.
People and their relatives told us their feedback was sought about the service that they received. They told us that improvements were being made to the service they now received.
The provider failed to provide evidence that they had a clear oversight of the service through regular auditing and effective quality assurance systems. We found that the acting manager has completed her own audits so was aware of the shortfalls that we have identified.