26 October 2015
During an inspection looking at part of the service
We carried out an announced comprehensive inspection of this service on 4 June 2015. Seven breaches of the legal requirements were found. The provider did not have effective processes to protect people from abuse and to investigate any allegation of abuse. The Commission had not been notified of allegations of potential abuse. The registered person did not assess the risks to the health and safety of service users and do all that was reasonably practicable to mitigate such risks. Recruitment and selection procedures were not followed, robust or safe. Staff who were recruited did not have the skills, experience and appropriate induction training to meet people’s needs. Supervisions, appraisals and spot checks were not completed for staff. The principles of the Mental Capacity Act were not understood or applied when gaining the consent of people who received care. Care plans were not designed with a view to achieving people’s preferences and ensuring their needs were met. The provider did not have effective systems to improve the quality and safety of the service provided. Records relating to the care of people were not accessible or available to the Commission. After the comprehensive inspection, four warning notices were served and the provider wrote to us to say what they would do to meet legal requirements in relation to these breaches.
We undertook this announced comprehensive inspection on 26 October 2015 to check that they had followed their plan and to confirm that they now met legal requirements. At the inspection on 26 October 2015 we found that sufficient improvements had not been made, the service had not reached the standards required by the regulations and had not met the requirements of the warning notices.
Anoft Global Resources Limited is a domiciliary care service which provides care and support to adults and older persons in their own homes. At the time of the inspection there were eight people using the service. There were three care staff, the owner who is the registered provider and the registered manager who also provided care to people.
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.
People were not always safe when they received personal care. Care staff were not confident in identifying and describing the signs of potential abuse. Safeguarding concerns were not identified and investigated. Incident, accidents and risks relating to the health, safety and welfare of people were not identified, monitored, written down or reviewed. Safe recruitment and selection processes were not followed.
Staff did not receive an effective induction, training or supervision programme. Staff, the provider and registered manager had not received training on the Mental Capacity Act 2005 and were not confident to put this into practice.
People’s views and wishes were listened to but not always acted upon. People did not always receive care in a respectful and dignified way.
People felt they were involved in the assessment of their needs and planning of their care; however care plans did not always reflect people’s preferences. People did not always receive care that was reflected in their care plan and centred on them.
The registered manager and provider did not have a good understanding of their roles and responsibilities. Effective systems and processes were not in place to assess, monitor and learn from quality audits, incidents, accidents and safeguarding concerns. The Commission had not been notified of safeguarding concerns. The provider had not displayed their ratings from their previous inspection.
The overall rating for this service is ‘Inadequate’ and the service is therefore 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.
We found a number of continued and new breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found the provider was in breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of this report.