7 August 2014
During an inspection in response to concerns
Below is a summary of what we found. The summary is based on discussions with eight people who received a service from the agency, four relatives, six care workers, two office staff, the manager and two representatives of the provider. We also reviewed records that related to the management of the service. These included staff records, audits, action plans, policies and procedures, complaints, accidents and four people's care and health records.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
There was a lack of robust contingency planning in place to manage the shortage of care workers employed at the agency. This meant that people were at risk of not receiving the care and support they needed at the agreed times. A compliance action has been set and the provider must tell us what they are going to do to achieve compliance.
Is the service effective?
The agency had attempted to manage critical staffing levels. This had impacted on the effectiveness of service provision. This meant that at times, people's needs had not been met in full, staff had not been fully supported and systems had not been used in full to monitor the quality of service provided.
Is the service caring?
All but one person that we spoke with said that they were happy with the care workers who visited them. Comments included, 'I have one lady who comes, she is an absolute diamond. Our backgrounds are similar and we get on so well. I requested that she comes every day and so far she has'. Another person said, 'They are very, very nice to me, helpful and cheerful'.
Is the service responsive?
The agency had monitoring systems in place to take action on an individual basis, but there was very little evidence that systems took into account issues at an organisational level. This meant that trends had not been identified and acted upon in a timely manner.
Is the service well-led?
A new manager was in post at the agency and we were informed they were going to submit an application to register with us. Many of the care workers that we spoke with expressed the view that the new manager supported them to undertake their roles and responsibilities. For example, one care worker told us, 'The new manager is brilliant. I can contact him anytime'. Other care workers felt that they did not get the support they needed. As one explained, 'We are supposed to get travelling time between visits, but this does not always happen. The office let us down'. Due to the critical staffing levels that the agency had attempted to manage, the provider had allocated a number of other senior managers to support the running of the agency. We found that the manager and representatives of the provider were open to suggestions and to making improvements. However we found that leadership at the agency was reactive rather than proactive particularly over the last three weeks since they had needed to return care packages to the local authority due to the staffing situation at the agency.
Information about the safety and quality of the service had not been gathered systematically and used to improve outcomes for people. This included a lack of audits and analysis of incidents and events that affected people who used the agency. As a result, monitoring systems did not help ensure the quality of services provided by the agency continually improved. We are following up this with the provider and will report on our actions at a later date.