Archived: Community Care Support

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.

There was no registered manager in post at the time of our inspection. 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.

At this inspection we identified breaches 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.

The service was not consistently safe. There were potential safeguarding incidents that we saw documented that had not been reported to the local safeguarding authority in order to protect people who used the service. Not all staff were aware of what constituted abuse and not all staff understood their responsibilities.

Risk assessments were in place but they had not always been updated following a change in some people’s needs so different or new staff would not always know what to do.

Medicines were not managed safely and guidance for staff was not always available. Records of the administration of medicines were also not always completed correctly.

Staff had not always been recruited safely. There was not always evidence of a criminal records check being carried out, of suitable references being sought and of exactly which staff were supporting people in their homes.

We could not be sure that all staff had sufficient training as records did not always reflect the different staff working at the service.

There was no provider oversight of the service. There was confusion about the management of the service and effective systems to monitor the service were not in place.

We could not be sure that staff were being deployed effectively due to it not being clear who still worked for the service.

Evidence that other health professionals had been involved in people’s care was not always available and guidance was not always followed.

Some people were supported by staff with their food and drinks. Risks associated with this were not always being managed.

Complaints were not always responded to and people and relatives found it difficult to speak to someone from the service to discuss their concerns.

It was not always clear whether care plans and risk assessments had been reviewed and changes in people’s needs had not always been updated.

The service was not always caring as it had not taken appropriate steps to ensure staff were suitable and sufficiently trained to support people. Some people and relatives were complimentary of their regular staff. However, people were not always supported by regular staff.

People and relatives told us they felt safe with staff.

The Mental Capacity Act 2015 had been taken into account and people were supported to make choices.