18 March 2019
During a routine inspection
People's experience of using this service:
¿ People and their relatives told us staff were caring and provided a service that made them feel safe, promoted their independence and had a positive impact in their lives.
¿ We found that the service had deteriorated in some domains since our last inspection. However, the domains relating to caring and effective have remained the same.
¿ The service met the characteristics of requires improvement in three out of the five key questions.
¿ We found two breaches of the regulations. One breach in relation to good governance because of lack of consistency in the quality of records relating risks to people’s care, support required and their consent. Management's oversight has not always been robust in how risks to people and medicines were managed by the service. We found a second breach because the provider failed to notify the CQC of safeguarding incidents.
¿ The management of risks was not always consistent. We found known risks to people’s care were not always identified in their risk assessments.
¿ Medicines were not always managed safely. The provider had identified in their internal audits that this was an area that required improvement and actions were being taken to address the issues. We made a recommendation about medicines.
¿ The provider had several systems in place to monitor the quality of the service but their effectiveness was not always consistent. The provider had identified some areas that required improvement however, other areas such as the recording and monitoring of risk associated to people’s care and the lack of submission of statutory notifications had not been identified before this inspection.
¿ The service had a registered manager in place but the day to day running of the service was the responsibility of the business manager. We found management’s oversight of accidents and incidents and compliance with legal requirements was not always robust.
¿ Most people and relatives told us care was provided by a regular team of staff.
¿ People and relatives told us they had been involved in setting up and reviewing their care and were confident that any concerns raised to the provider would be appropriately acted upon.
¿ Staff told us they enjoyed their job and most of them felt well supported through regular supervision and assessments of their competency and training.
¿ The provider had developed several links with the community and partnerships to support care provision and service development.
¿ For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Ratings at last inspection:
At our last inspection the service was rated good overall. Our last report was published on 16 September 2016.
Why we inspected:
This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Enforcement:
Information relating to the action the provider needs to take can be found at the end of this report.
Follow up:
We will continue to monitor the service to ensure that people received safe, high quality care.
Further inspections will be planned for future dates. We will follow up on any breaches of regulations at our next inspection.