Archived: East Riding Quality Home Care

Updated 16 November 2018

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.

This inspection took place on 24, 25, 26, September and 2 October 2018 and was announced. We gave the service four days’ notice because it is small and we needed to be sure people who used the service and staff were available to speak with us. Inspection site activity started on 24 September 2018 and ended on 2 October 2018. On 24 September, we spoke on the telephone with three people who used the service, three relatives and six staff members. On 25 and 26 September we visited two people in their own homes and visited the office location and spoke with the provider and business manager. On the 2 October 2018 we visited one person in their home. The inspection team consisted of two adult social care inspectors.

Prior to the inspection, we reviewed all the information we held about the service. This included notifications the provider had sent us. A notification is information about important events which the provider is required to tell us about by law. We contacted the local authority safeguarding team and the local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services. We used their feedback to plan the inspection.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We looked at a range of documents and records related to people’s care and the management of the service. We looked at four care plans, four staff recruitment files, supervision and training records and minutes of staff meetings. We also looked at quality assurance audits, complaints and a selection of policies and procedures.

Updated 16 November 2018

This announced inspection visit activity started 24 September 2018 and ended 2 October 2018. We gave the provider four days’ notice of our visit. We did this as we wanted to make sure the provider was available on the day of the inspection, and visits to people in their own home could be arranged (with consent). The inspection was completed by two inspectors.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults.

Not everyone using East Riding Quality Home Care receives the regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. There were 37 people using this service at the time of our inspection, 25 people were receiving a regulated activity.

There was a registered manager in post at the time of the 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 registered manager, who had been the previous provider, was not present at the time of inspection. Since the last inspection they had sold the service to a new provider and the service was in a period of transition. The new provider was present at the inspection.

People told us they felt safe, however staff had limited knowledge on safeguarding procedures. Risk assessments had not always been carried out when people had an identified need.

People received their medication safely although there were some issues with recording and auditing medication records.

It was unclear from peoples care records if they had the capacity to consent to their care plans.

Staff received training although we identified gaps in subjects meaning we could not be assured staff had the knowledge to meet people’s needs. Some staff had not received training in first aid, infection control, mental capacity act 2005 and equality and diversity. We were unable to see evidence for some staff of induction records.

Staff were not receiving appraisals, or meeting with the provider regular as stated in their policies. The provider showed evidence they had systems in place where they were in regular contact with staff and staff could raise any concerns.

Person centred detail was not always included in people’s care records. People’s care records did not always say how they like to receive support. The new provider informed us they were updating all care plans across the service. However, this work had not been completed when we inspected the service. The provider carried out regular reviews with people.

People and relatives told us staff were caring. We saw that staff knew people well and had good relationships. People's privacy and dignity were respected, and they were encouraged to be independent.

The provider used technology to monitor people’s calls and ensure calls where not missed. The system in place alerted the provider if staff where fifteen minutes late. The system ensured no calls where missed.

The provider had not operated a robust quality assurance system. Audits carried out had not identified the shortfalls which we found during this inspection. Where audits had highlighted improvement areas action had not always been taken to address them.

People and staff spoke highly of the new provider who had recently taken over the service.

Records had not always been completed fully.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection. You can see what action we told the provider to take at the back of this report.