Archived: Community Care Support

Updated 24 May 2018

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 was 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 took place on 20 March 2018 and was announced. The inspection team consisted of two inspectors.

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 20 March 2018 and ended on 23 March 2018. It included telephone calls with people and/or their relatives and we called staff to assess their knowledge of people they supported and the procedures they needed to follow. We visited the office location on 20 March 2018 to see the manager and to review care records and policies and procedures.

We had not requested the provider to complete a Provider Information Return because we had brought the inspection because we had concerns about the management structure within the service and were concerned that the required improvements needed after the last inspection had not been progressed.

Before the inspection site visit we reviewed the information included we held about the service, such as feedback from staff and people. We also checked any notifications we had received from the provider about events that had happened at the service, which the provider is required to send us by law. For example, serious injuries, safeguarding concerns and changes to the service provided.

We spoke with one person who used the service. People who used the service had difficulties communicating, so we also spoke with four relatives to gain their views and experiences of the support provided. We also spoke with three staff members and the manager. We viewed four records about people’s care and records that showed how the service was managed. This included training and induction records for five staff employed at the service.

Updated 24 May 2018

We carried out an announced inspection at Community Care Support on the 20 March 2018. At the last inspection in November 2017, we found breaches in regulations because medicines were not managed safely, people’s risks were not mitigated, people were not always safeguarded from potential abuse, staff did not have sufficient training and had not been recruited safely. There was a lack of governance at the service and systems were not in place to monitor the service to mitigate risks to people. We asked the provider to take action to make improvements and we found that there had been some improvements. However, we found that was still a breach in regulations and the provider still needed to make improvements to the way the service was managed.

This service is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to older adults and younger adults who have a physical or learning disability. At the time of the inspection there were four people who used the service.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

There was not a registered manager at the service. 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. We were told that the co-director of the service planned to submit an application to become the registered manager. This had not been completed at the time of the inspection.

We found there was a continued breach in Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

There continued to be a lack of governance at the service. We found that there were not effective systems in place to monitor and manage the service. This meant there was a risk that unsafe and ineffective care was not identified.

The provider was not meeting the requirements of their registration and they were not displaying their previous inspection rating as required by law.

Improvements were needed to ensure that records contained accurate and up to date information.

Improvements were needed to ensure that there was sufficient guidance for staff when applying creams and medicine records were not always available.

Further improvements were needed to ensure that the provider followed safe recruitment procedures and staff had sufficient knowledge and skills to carry out their role.

Improvements were needed to ensure people’s cultural and diverse needs were planned for to enable a fully individualised care provision that met people’s preferences.

The provider was following the principles of the Mental Capacity Act 2005. This meant that people were receiving care that was in their best interests.

People’s care was reviewed. However this information had not been included in people’s records to ensure they received care that met their changing needs.

People were supported to eat and drink sufficient amounts and nutritional risks were assessed and monitored.

People’s health was monitored and health professionals input was sought where needed.

Staff were aware of their responsibilities to protect people from the risk of harm. Staff knew people’s risks and supported them to remain as independent as possible whilst protecting their safety.

There were enough staff available to meet people’s needs in a timely way. Infection control measures were in place to protect people from the potential risk of cross infection.

People were supported by kind and caring staff.

People’s choices were promoted and respected by staff in a way that promoted people’s individual communication needs. People’s dignity was maintained and their right to privacy was upheld.

People received care from a consistent staff group which met their individual needs and preferences.

People and relatives knew how to complain and the provider had a complaints procedure in place.

People, relatives and staff felt able to approach the manager. Staff felt supported by the manager.

Feedback about the quality of care had been gained from people and checks on staff performance had been completed to ensure people were receiving the care required.