Archived: Lancaster

Updated 13 January 2017

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.

We undertook an unannounced focused inspection of Lancaster on 03 and 09 March 2016. An announced visit was undertaken on 15 March 2016. This was so that we could ensure personnel we wished to speak with would be available.

We carried out this inspection as we had received concerns regarding risk management and the safety of people receiving a service. The team inspected the service against one of the five questions we ask about services: ‘Is the service safe?’

The inspection was undertaken by three adult social care inspectors and an inspection manager.

Prior to our unannounced inspection, we reviewed the information we held about Lancaster. This included notifications we had received from the provider about incidents that affected people who used the service. We checked safeguarding alerts, comments and concerns received about the service. We also spoke with the safeguarding team and commissioning department at the local authority. They told us they had significant ongoing concerns about Lancaster and Heritage Homecare Services Ltd. We did this to gain an overview of what people experienced who received support from the service.

We spoke with a range of people about this service. They included the registered manager, two staff members, four people who received a service and one relative. We looked at staff rotas for the time and duration of visits. We compared these against information held on the electronic call monitoring system for the actual time and duration of the visit. We focused on how staff provided care within a geographical area and if they had enough time to travel between clients. We looked at how many visits a staff member had completed per day. We looked at fourteen peoples’ care records who received support from Lancaster.

Updated 13 January 2017

We carried out an unannounced focused inspection of this service on 09 and 14 December 2015. This was because we received information of concern about the service. The concerns related to missed and late visits, administration of medication and delivery of the care provided.

After the inspection in December 2015, we received further concerns about missed and late visits. We also received information of concern regarding the disposal of important records. As a result, we undertook a further focused inspection on 03, 09 and 15 March 2016.

We undertook this focused inspection to assess if people were safe. The visit on the 03 and 09 March was unannounced. The provider was notified prior to our visit on the 15 March 2016. This report covers our findings in relation to this inspection only. You can read the report from our last inspection by selecting the 'all reports' link for Lancaster on our website at www.cqc.org.uk.

At this inspection we judged the provider continued to be in breach of Regulation 12 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe Care and Treatment and Regulation 17 Health and Social Care Act 2008 (Regulated Activities) Good Governance. The service was also in breach of Regulation 9 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Person Centred Care and Regulation 18 Care Quality Commission (Registration) Regulations 2009 Notification of other incidents.

Lancaster is registered to provide personal care to people living in their own homes. At the time of our inspection, 31 people were receiving a personal care service. The office is based at Riverway House, which is situated between Lancaster and Morecambe. The service provides care and support for older persons, dementia care, end of life care, long-term conditions, respite care and night care.

There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 looked at electronic systems and documentation that showed not all people who required support receive their scheduled visits. This left them at risk, because the provider did not provide the care and treatment identified to meet people’s needs.

Records we looked at showed people who required a service did not always receive their allocated support time. We saw that the length of time carers were due to stay with people as part of a scheduled visit had been shortened to allow staff to complete additional visits elsewhere.

We saw examples of where people who were scheduled four visits a day, had received three visits because two of the visits had been merged. This placed vulnerable people at risk. They did not receive safe and effective support with their physical and mental health requirements.

Risks were identified with the electronic monitoring system. The system was not effective as it did not always show when visits had not occurred. When the system did show missed visits, the staff member operating the system was unable to explain why they had occurred.

People were not given the support they needed with medicines as directed within the care plans.

Ongoing medical conditions were not managed safely.

Care plans identified risks, although information was brief and lacked detail to guide staff on how to manage the risk. This placed people at risk of harm.

There were safeguarding policies and procedures in place. We saw the provider had raised a safeguarding concern with the local authority in relation to theft. They had not notified the Care Quality Commission as required.

You can see what action we told the provider to take at the back of the full version of the report.