Archived: Swanborough Services - Burgess Hill

When we inspected the service in June 2014 we found that care was not always planned and delivered in such a way as to meet people's individual needs, that staff had not always received appropriate training and that accurate records had not been maintained. Following our visit, the provider sent us a report setting out the action they would take to meet the regulations.

This inspection was carried out by an adult social care inspector. We spoke with the manager, three administrators, nine care workers, six people who received a service and three relatives. We looked at six people's care records and five staff files. We visited one person in their home and met with one of their relatives. We spoke with all of the other people, their relatives and care workers by telephone following our visit. We considered all the evidence we had gathered. We found that the manager had taken action to address the concerns identified at our last inspection but that further action was required to meet the regulations.

People's care had been planned and care plans included detail for staff on how to meet their needs. We found that care plans had been updated and reviewed. People, their relatives and staff told us that there had been improvements in the service. One relative said, 'They are improving, the staff seem more content'. A member of staff told us, 'In the last two to three months I have seen a big change. It has definitely changed for the better'.

The service had increased their training offer and weekly training sessions had been introduced. We found, however, that there was no clear system to record the training delivered and to plan for future training needs. This meant that some staff had not been trained or received refresher training in areas such as moving and handling or administering medication. This meant that staff may not be supported to care for people safely and to an appropriate standard.

We found that the service had made improvements in record keeping in relation to people's care but that records relating to staff training were still not fit for purpose.

We have asked the provider to tell us what further action they are going to undertake in order to meet the requirements of the law in the areas of staff training and record keeping.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with six people who used the service, seven relatives, the registered manager and nine members of staff. We also reviewed records relating to the management of the service which included three people's care records, six staff files (three for existing staff and three for newly recruited staff), policies and procedures, accident records, complaints and audit reports. At the time of our inspection the service was providing personal care to 32 people, 18 in the community and 14 in supported living accommodation.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People's needs had been assessed but the service did not always have a care plan in place to describe how staff should meet those needs. Some care plans did not contain sufficient detail. This meant that people were at risk of receiving care that was inappropriate or unsafe. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to planning and delivering care to meet individual needs and to ensure people's welfare and safety.

We found that records relating to people's care, staff training and the management of the service were not always accurate. Some records could not be located promptly when required. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to records.

We looked at the recruitment processes and found them to be safe and thorough. The service had carried out relevant checks to ensure that staff had the necessary skills and experience.

Is the service effective?

The majority of people told us that they were satisfied with the service that they received. They told us that there had been a lot of staff changes but that in recent months there had been more continuity. Most people told us that they had difficulty communicating their needs to some staff. This was because a number of staff did not speak English as a first language. This meant that people might be put at risk because they were unable to communicate their needs or any problem.

We looked at staff training records which indicated that there were significant gaps in staff training. Staff that we spoke with told us that weekly training had recently been introduced. They told us that they felt equipped to do their jobs and that they were happy with the training opportunities available to them. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to ensuring that staff receive appropriate training to enable them to deliver care safely and to an appropriate standard.

Is the service caring?

People were supported by kind and attentive staff. We visited three people in their homes, two when staff were visiting. We saw that staff were patient and gave encouragement when supporting people. People that we spoke with expressed some frustrations over the punctuality of visits but were satisfied with the care that they received. One said, 'They do their job, I think they're very good'. Another told us, 'We have a laugh'. A relative told us, 'They really care' and said, 'The girls are very nice people, they really are'.

Is the service responsive?

People, their relatives and staff told us that they were able to raise suggestions or concerns. One relative told us, 'We're very happy with Swanborough'. Where issues or concerns were identified we noted that the service had taken appropriate action. We found that the service listened and responded to feedback received from people, their representatives and from staff. One member of staff said, 'It's getting better now'.

Is the service well led?

We saw that there were systems for monitoring the quality of services provided. The manager demonstrated a commitment to making improvements to the quality of service provided to people. We noted that new systems for training, staff meetings, spot checks and supervisions had been put in place. The manager explained that the service had been through a difficult period but that, 'In the last six to eight weeks things have settled down'. The manager was aware of issues in the service and was taking action to address them.

The people we spoke with told us they were happy with the care they had received and with the staff team. One person who used the service told us 'I'm more than happy with the care I get. The carers are like friends to me'. Another person told us 'They are very nice to me. I don't know what I'd do without them'. Staff we spoke with had a good understanding of the support needs of people who used the service. One member of staff we spoke with told us 'I think we provide great care. We never do a bad job'.

We found that consent was sought and obtained before any care and treatment was provided. We saw that the service had an appropriate recruitment system in place.

We found that there was an effective system in place to support workers with regular one-to-one supervision, appraisals, training and studying opportunities. We also saw that the service had systems in place to receive, handle, respond to and learn from complaints.

We found that staffing was well managed within the service. This meant that care was provided for people when booked. People who used the service told us the staff were kind and caring. People told us staff usually arrived on time for the booked appointment.

We found that staff were knowledgeable regarding each person who used the service. We examined the care records of five people who used the service. We found that people understood care and treatment choices available to them.

The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff had received training in safeguarding of vulnerable adults, safeguarding was a key topic for all meetings and discussed during staff supervision.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. The provider evidenced to us that there was continuous monitoring of the quality of service provision to people who used the service.