Archived: Carebank Ltd

The inspection team included an inspector and an expert by experience. The team gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well- led? The expert by experience gathered information from people using the service by telephoning them.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe with staff assisting them with their personal care needs. One person said, “My carer lets herself in with the key safe and locks the door when she is done.”

We found the agency had a safeguarding policy which was in line with the multi-agency policy. Staff were aware of the different types of abuse and what action to take if they suspected abuse had taken place. Systems were in place to ensure that lessons were learnt from safeguarding investigations. This reduced the risk to people and helped the service to continually improve.

We found that records relating to people’s medicines were not appropriately maintained. For example, handwritten entries on the medication administration record (MAR) sheets seen had not been countersigned by a second staff member to minimise the risk of errors when transcribing and were illegible. A person had been prescribed a course of antibiotics. The dose and frequency prescribed had not been recorded on the MAR sheet. This meant that they had been a breach of the relevant legal regulation (Regulation 13). The action we have asked the provider to taken can be found at the back of this report.

Is the service effective?

We found that people’s needs had been assessed before the agency provided them with a care package. People were involved in the planning and development of their care plan which they had been asked to sign.

Staff spoken with said that they had been provided with appropriate induction training and records seen supported this.

We found that supervision and appraisal for staff had been irregular. This demonstrated that people were not cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. This meant that there had been a breach of the relevant legal regulation (Regulation 23(1) (a). The action we have asked the provider to take can be found at the back of this report.

Is the service caring?

We spoke with twenty-two people being supported by the agency. We asked them for their opinions about the staff that supported them. Comments from people were positive. For example, one person said, “My carers let me do the tasks I can still do and assists me with the more challenging tasks.” A second person said, “When my wife died my regular carer spent time with me and really pulled me through.” This demonstrated that people felt that they had developed a caring and positive relationship with the staff who were caring for them.

Is the service responsive?

The people we spoke with said that they knew how to make a complaint however, not all of them had confidence in the agency’s complaints process. We found that the agency maintained a record of complaints and these had been investigated. Not all the complaints investigated provided a clear audit trail of the outcome of the investigation to verify that complaints had been resolved to people’s satisfaction.

Is the service well-led?

We found that the agency had quality assurance processes in place but these had not been fully embedded. For example, the outcome from a recent telephone survey identified areas as requiring attention but an action plan had not been put in place to detail how those areas requiring attention would be addressed. Action plans from audits relating to the daily record and medicine sheets did not always identify a completion date, or a named person to take responsibility for the action. We found that quarterly care workers meetings had not been taking place as scheduled. This demonstrated that meetings were not regularly held to enable staff to make suggestions and influence changes to the care provision. This meant there had been a breach of the relevant legal regulation (Regulation 10 (1) (a)(2)(b)(i). The action we have asked the provider to take can be found at the back of this report.

At the time of our inspection visit, the agency did not have a registered manager in post but there was an interim manager. Staff spoken with said that they felt well supported and listened to by the interim manager. They said and that the manager operated an open door policy and was supportive.

We spoke by telephone with three people who used the service and a family member. We also spoke with two staff members.

People we spoke with said that they were happy with the care they were receiving. They told us they knew how to contact the service out of office hours and in an emergency. People described staff as “very good and marvellous”. Staff spoken with confirmed that the on-call and emergency system had improved.

We found that the provider had put adequate measures in place to ensure that people would be able to contact the service in an emergency or otherwise.

The four people whom we spoke with said that they were aware how to make a complaint. One person said, “I made a complaint against a …and was happy with how it was investigated by management”. Another person said, “I have been provided with information on how to make a complaint but have never had the need to make one”.

We found that the provider had reviewed its complaints process and procedures. This was to ensure that complaints and comments raised by people who used the service were dealt with effectively.

Nine out of the10 people we spoke with said they were either very satisfied or satisfied with the service provided. People confirmed that they felt safe and that their privacy and dignity was respected. They told us that the staff treated them well. One person told us they got “care in the full sense, not just physical but psychological interaction too.” Another person said the staff were “so polite and friendly."

However, we also learnt that there were problems with communication which meant that at times people did not have reliable access to someone from the office, in an emergency or otherwise. We found that when people did provide feedback to the service, inconsistencies in the way information was recorded and handled, meant that they could not be certain that their comments and complaints had been dealt with effectively.