Background to this inspection
Updated
24 May 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 30 March 2016, with follow up telephone calls being made to staff and people who used the service, and their relatives where appropriate, on 5 April 2016. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the office. The inspection was carried out by an adult social care inspector. Prior to our inspection, we looked at the information we held about the service and considered any information we had received from third parties or other agencies.
As part of our inspection we visited the registered office and looked at three care plans and associated records such as daily notes and medication administration records, three staff recruitment files, the training matrix, records relating to quality assurance and audits, policies and procedures and records of accidents and incidents. We spoke with two people who used the service and three relatives of people who used the service. We also spoke with three members of care staff, the manager and the nominated individual, who was involved in the day to day running of the service.
The registered provider had been asked, during December 2015, to complete a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. The PIR had not been returned by the registered provider to CQC so could not be used to inform the inspection.
Updated
24 May 2016
The inspection took place on 30 March 2016 and was announced a day prior to the inspection. This was to ensure there would be someone in the office on the day of the inspection. Follow up telephone calls were made to people and staff on 5 April 2016. The service had previously been inspected in December 2013 and was found to be compliant with the Health and Social Care Act 2008 Regulations at that time.
The service provides domiciliary care services to people in their own homes. The people who receive these services have a wide range of needs and most are older people. The service provides minimum call times of 30 minutes. At the time of the inspection there were 16 people receiving support from the service.
The service did not have a registered manager in post at the time of our inspection. 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. The previous registered manager had recently left the service and was in the process of deregistering as the registered manager. A new manager had been appointed but was not yet registered and the nominated individual was overseeing the day to day running of the service.
People told us they felt safe and staff had received safeguarding training in order to keep people safe. Staff understood their responsibilities in relation to safeguarding people from abuse or harm and appropriate action was taken when necessary to protect people.
Risks to people were not always assessed and therefore measures to reduce risks were not always given consideration. This demonstrated a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The recording of the administration of people’s medicines was not safe. Records did not provide a clear and accurate record of the medicines people were prescribed and the medicines which staff had administered. This demonstrated a further breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
There were enough staff to meet people’s needs and there were robust recruitment practices in place, which meant staff had been recruited safely.
Staff told us they felt supported and staff had received induction and training. However some staff had not fully understood their training. Although staff felt supported, regular formal supervision did not take place.
People and relatives we spoke with told us staff were caring. People’s privacy and dignity were respected and people received support in terms of their religious and cultural needs. Staff developed positive relationships with the people they supported.
Care and support plans were detailed and personalised, taking into account people’s choices and preferences. People told us they had been involved in their care planning and felt they could make their own choices.
People and staff felt the service had improved since the beginning of the year. Staff felt supported and people felt able to contact the office in the knowledge they would be listened to. The manager had begun to audit some areas of practice. However, auditing systems were not yet robust and areas which had been identified as requiring improvement through the inspection process had not been identified through auditing. This demonstrated a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
You can see what action we told the provider to take at the back of the full version of the report.