Archived: Thirsk Community Care

Updated 22 May 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) 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 Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

One inspector visited the service.

Service and service type

This service is a domiciliary care agency. It provides personal care to children and young people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave 72 hours’ notice of the inspection visit because it is small and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection site visit activity started on 2 April and ended on 24 April. We visited the office location on 2 and 10 April.

What we did before the inspection

We used the information the provider sent us in the Provider Information Return (PIR). This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We contacted the local authority commissioning and safeguarding teams. We used this information to plan our inspection.

During the inspection

We reviewed a range of records. We looked at four children and young people’s care records and an incident report. We reviewed two staff files in relation to recruitment and two staff supervision records. We looked at volunteer and staff training records. We spoke with one volunteer, one member of staff, the registered manager, the service manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

After the inspection

We continued to seek clarification from the provider to follow up our findings. We reviewed a sample of the provider’s policies and procedures. We received feedback from three relatives and five volunteers.

Updated 22 May 2019

About the service

Thirsk Community Care is a domiciliary care service providing personal care for children and young people aged four to 18. Volunteers provide a sitting service for children and young people with disabilities. A sitting service is where a child or young person is supported for a few hours at a time, providing their parents with a break from their caring role. Staff arrange the visits and support the volunteers. The service was supporting five children and young people at the time of the inspection.

Not everyone using Thirsk Community Care receives regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

People’s experience of using this service and what we found

Systems were not in place to monitor the quality and safety of the service children and young people were receiving. Up-to-date records were not in place to reflect the current needs of children and young people and inform the support volunteers provided. Reviews were not documented to consider the effectiveness of their support.

There was an increased risk to children and young people as safe recruiting processes for staff and volunteers were not always followed. Children and young people were put at risk as staff and volunteers had not always received training relevant to their roles or updated their training to ensure they were following current best practice guidance. The registered manager did not complete observations or competency assessments of staff or volunteers.

Children and young people were not supported to have maximum choice and control of their lives and staff did support them in the least restrictive way possible; the policies and systems in the service did not support this practice. The provider did not follow the Mental Capacity Act 2005 when children and young people turned 16 years old to consider if they could consent to their care and support.

Volunteers understood children and young people’s behavioural needs and how to manage these. When incidents occurred these were used to improve the service and identify where support from other services may be needed.

Children and young people looked forward to visits from their regular volunteers, with whom they had formed close relationships. The service was valued for the practical, compassionate support it provided to families.

Volunteers had a detailed understanding of children and young people’s needs and routines, enabling them to provide person-centred care. Visits from volunteers provided parents with valuable respite away from their caring roles.

The service was well regarded in the local area and was looking at ways to develop and extend the support it offered to children, young people and their families.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

At the last inspection the service was rated requires improvement (published 10 April 2018). The service remains rated requires improvement. The service has been rated requires improvement for the last two consecutive inspections.

Previous breaches

Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection sufficient improvement had not been made and sustained. The provider is still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We identified four breaches in relation to consent, governance, staffing and fit and proper persons employed. Please see the 'action we have told the provider to take' section towards the end of the report.

Follow up

We will meet with the provider to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.