Archived: Elderly Care Services

Updated 19 August 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.

The inspection took place on 5 July 2016 and was announced. We gave the provider 48 hours’ notice as they provide a domiciliary care service and we needed to arrange for someone to be in the office to speak with us.

The inspection team consisted of one adult social care inspectors, an inspection manager and an expert by experience. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service. Their expertise was in supporting an older person using care services.

Before the inspection we reviewed all the information we held about the service, including past inspection reports, action plans, notifications from the provider and the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also contacted Healthwatch to ask if they had any information about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. They did not provide any information of concern.

During the inspection we spoke with the nominated individual, the former registered manager, five people who used the service and two relatives of people who used the service. We spoke with three members of staff. We spent time looking at records including seven people’s care plans, five staff recruitment records and other documents relating to the running of the service.

Updated 19 August 2016

Our inspection took place on 5 July 2016 and was announced. At our last inspection in October 2015 we found the provider was in breach of regulations relating to consent, safe care and treatment, acting on complaints, governance and recruitment and support of staff. We rated the service as inadequate. At this inspection we found the provider had made improvements in staff supervision and managing complaints.

There was no registered manager in post. The registered manager had de-registered with the care quality commission but still worked in 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.

Elderly Care Services provides personal care to people in their own homes in Leeds and the surrounding areas. At the time of the inspection there were eight people using the service.

People told us they felt safe receiving care and support from the service, however we found risk was not well documented. Information relating to risks associated with people’s care and support was not always consistently documented and was not used to produce meaningful guidance to staff to help minimise those risks.

We found recruitment practices were not always safe because the provider was not ensuring they had made robust checks to ensure people they employed had not been barred from working with vulnerable people.

Medicines were well managed, and we found evidence the provider was checking to ensure staff practice in assisting people with their medicines was safe. People told us they were happy with the support they received in this area.

There were sufficient staff employed in the service to enable the provider to provide care and support to people. There was flexibility to increase staff’s hours where need arose. Although the provider did not monitor call times and attendance, the small size of the service meant they were in regular contact with people who could tell them about any concerns with staff attendance.

People told us they were confident staff were well trained, and staff did not raise any concerns with the training provided. We found there was a lack of planning to ensure that training was refreshed to ensure it remained effective, and staff told us they completed training online in their own time.

The provider did not demonstrate good understanding of the regulatory requirements relating to the mental capacity act and we found consents were not always appropriately recorded.

Staff told us they had monthly supervisions with their line manager, and told us these were useful conversations they found helpful. We saw evidence supervisions were happening monthly.

People gave positive feedback about their relationships with staff and staff told us about ways in which they worked to ensure they protected people’s privacy and dignity and promoted their independence.

There had been a full review of care plans since our last inspection, and new documentation was in place. We saw these were not always signed by people, and many documents lacked dating and an indication of when they should be reviewed.

We saw care plans contained information relating to people’s likes and dislikes which evidenced their involvement with the process of writing the care plans. People told us they felt they had some involvement.

The provider had made improvements to their processes for handling complaints, but had not received any since our last inspection. People we spoke with told us they felt confident they could raise concerns if needed.

The registered manager had de-registered with the CQC, although they still worked in the service. At the time of our inspection there was no registered manager in post, although we saw evidence the provider was actively trying to recruit.

Staff we spoke with referred to the supervisor when they spoke about leadership in the service, although they said they found the provider approachable if they needed to speak to them. Staff we spoke with did not know about the change in the registered manager’s status.

We saw policies and procedures were not personalised to the service and contained lengthy documentation. These were not always followed by the provider.

We did not find adequately robust governance systems in place. Audits were not comprehensive or meaningful, and people’s feedback was not well used as a means of assessing or improving quality in the service.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.