Archived: East Lancashire Deaf Society

Updated 28 July 2016

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 is 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 30 June 2016 and was announced. In accordance with our guidance we gave the provider 48 hours’ notice that we were undertaking this inspection; this was to ensure that the registered manager and staff were available to answer our questions during the inspection. This announced inspection was carried out by one adult social care inspector supported by a British Sign Language interpreter.

Before this inspection we reviewed the completed provider information return (PIR); this is a document that asked the provider to give us some key information about the service, what the service does well and any improvements they are planning to make. We also contacted the local authority contract monitoring and safeguarding teams, the local Healthwatch and two local authority social workers who had commissioned the agency to provide care to people in order to gather their views about the service; no concerns were raised with us.

During the inspection we visited the registered office and spoke with three people who used the service. We also spoke with the registered manager, the team leader, three support workers and a social worker who had supported a person who used the service to attend the registered office.

We looked at the care records for four people who used the service and the medication administration record (MAR) charts for one of these people. We also looked at a range of records relating to how the service was managed; these included staff recruitment and training records, quality assurance processes and policies and procedures.

Updated 28 July 2016

This was an announced inspection which took place on 30 June 2016. The service was previously inspected in April 2014 when it was found to be meeting all the regulations we reviewed at that time.

At the time of our inspection this service was registered with the Care Quality Commission (CQC) as East Lancashire Deaf Society. However the registered manager informed us the service was trading as Lancashire Rose Care Services, operated by East Lancashire Deaf Society. The provider was in the process of changing the registration information held by CQC in order to ensure this accurately reflected who was responsible for the service.

The service specialises in offering support to people who use deaf sign language by providing staff with appropriate communication skills. The range of services provided includes personal care, support with community activities and daily living. At the time of this inspection there were 13 people using the service across Lancashire and Cumbria.

The service had a registered manager in place as required under the conditions of their registration with the Care Quality Commission. 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.

During this inspection we found three breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. This was because recruitment processes were not sufficiently robust to protect people who used the service from unsuitable staff, a complete record had not been maintained of the support people required and quality assurance systems in the service were not sufficiently robust to identify this shortfall regarding care records. You can see what action we have told the provider to take at the back of the full version of the report.

When we looked at the recruitment records relating to three staff we noted all the personnel files included references and pre-employment checks. However we saw that the application form for one person contained gaps in employment which had not been explored by the registered manager at the time of interview; such checks are important to ensure people who use the service are protected from the risk of unsuitable staff. The registered manager told us they would amend their recruitment procedure with immediate effect.

We noted that there were no support plans in place on three of the care records we reviewed. The registered manager told us that they were relying on the assessment completed by the local authority to determine the support each person required, although they acknowledged that this did not give specific guidance to staff about how they should meet each individual’s needs. In addition they told us there was no system of care plan audits in place which would have identified that these records had not been completed. We were told that action would be taken to ensure support plans were put in place as a matter of urgency.

Staff had received training in safeguarding adults. They were able to tell us of the action they would take to protect people who used the service from the risk of abuse. They told us they would also be confident to use the whistleblowing procedure in the service to report any poor practice they might observe. They told us they were certain any concerns they raised would be taken seriously by the managers in the service.

We were told that staff were matched with people who used the service; this helped to ensure they had the best chance of getting on well together and being able to provide the support individuals required.

Although most people who used the service did not require support from staff to take their medicines as prescribed, we saw that arrangements were in place to ensure all staff received training in the safe handling of medicines. Spot checks were completed by the registered manager to help ensure that staff were working in line with the service’s policies and procedures regarding the safe administration of medicines.

Risk assessments for physical and mental health needs as well as environmental risks helped protect the health and welfare of people who used the service. Staff were aware of the action to take to prevent the risk of cross infection should they be required to provide personal care to people who used the service.

Where necessary people who used the service received support from staff to ensure their nutritional needs were met. People told us staff would accompany them to appointments if necessary to help them communicate their needs to health professionals.

Staff told us they received the induction, training and supervision they needed to be able to deliver effective care. We noted that staff had not completed specific training in the Mental Capacity Act (MCA) 2005; this legislation helps to ensure that people are supported to make their own decisions wherever possible. Both staff and the registered manager told us all people using the service at the time of the inspection were able to make their own decisions. The registered manager was aware of the action they would need to take if this situation were to change in order to ensure people’s rights were upheld.

The registered manager and staff we spoke with were caring and respectful in the way they spoke about people who used the service and the way they provided support. Staff demonstrated a commitment to providing person-centred care and supporting people to be as independent as possible.

We saw that systems were in place to involve people in reviewing the support they received. We were told that, if they considered a person’s needs had changed, the registered manager would contact the relevant local authority to request a review of the commissioned care package. This helped to ensure people received the appropriate level of support for their needs.

We noted that there was a complaints procedure in place for people to use if they wanted to raise any concerns about the care and support they received. We saw that the registered manager responded immediately they were informed of minor concerns a person had shared with us during the inspection. The registered manager provided feedback to us about the action they had taken to ensure the person always received the support they wanted.

Staff supported people to attend social activities, including deaf clubs, to help prevent social isolation and maintain people’s health and well-being. Social workers who had been involved in commissioning packages of care from the service told us they considered people received high quality care and support from staff.

Staff told us they enjoyed working in the service. They commented that the registered manager and other senior staff were always approachable and supportive. They also told us they felt able to use staff meetings to make suggestions as to how the service could be improved.