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Archived: New Care (Newton Abbot)

Overall: Requires improvement read more about inspection ratings

20 Courtenay Park Road, Newton Abbot, Devon, TQ12 2HB (01626) 331133

Provided and run by:
Select Living (Devon) Limited

Important: This service is now registered at a different address - see new profile

All Inspections

24, 25, 26 February and 11 March 2015

During a routine inspection

New Care (Newton Abbot) provides care and support to a range of people including older people and people with learning disabilities, who live in their own homes.

This location has a condition of registration that it must have a registered manager. 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. At the time of the inspection, the location did not have a registered manager. The provider had employed a manager who was in the process of applying to register with the Care Quality Commission.

We visited the office on 24 February 2015. At the time of our inspection 251 people were using the service. Our last inspection took place in August 2014. At that time, we found the service was not meeting the regulations in relation to care and welfare, medicines management, staffing levels, and quality assurance. We took enforcement action and told the provider they needed to make improvements. The provider sent us an action plan telling us what they were going to do to meet the regulations. On this visit we checked and found improvements had been made.

People and their relatives were pleased with the care they received and praised the staff. Comments included “I can’t fault the carers at all” and “They’re good, friendly and polite”. People were happy and relaxed when we visited them in their homes. Staff treated people with respect and kindness. People responded to this by smiling and engaging with staff in a friendly way.

People told us they felt safe when staff visited them to provide care. Most people had a regular group of staff who they knew and trusted. Several people said they would prefer staff they knew so they were more familiar with their needs and how they liked things to be done. The co-ordinator told us they did their best to provide regular staff but this could sometimes be difficult due to staff changes and absence.

Appropriate staff recruitment checks had been undertaken to ensure staff were suitable to work with people. Staff received safeguarding training and knew what to do if they were concerned that a person was being abused.

The provider employed enough staff to carry out people’s visits and keep them safe. New care packages were not taken on if they didn’t have enough staff available to cover all visits and provide emergency cover.

People’s visits were often late but they understood delays were sometimes unavoidable. People were not always informed of changes to their visits. They said they would appreciate a call so they knew what was happening. Several people said they had cancelled visits as they were later than their planned visit.

Staff understood the needs of the people they were supporting. Staff were trained to ensure they provided care and support that met people’s needs. They demonstrated a good understanding of their roles and responsibilities, as well as the vision of the service.

Each person’s care plan had been reviewed and updated. People and their relatives were involved in care planning. People were asked for their consent before staff assisted them. One person told us “When they arrive they always sit and read the file and check with me on what is to be done”.

People's medicines were managed safely. Some people managed their own medicines if they wanted to and if they had been assessed as safe to do so. Staff gave other people their medicines. People had received their medicines as they had been prescribed by their doctor to promote good health.

People were given a copy of the complaints policy and knew how to make complaints. However, the provider’s complaints procedure was not always followed and this resulted in complaints not being responded to appropriately. This was a breach of Regulation 16 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider had systems in place to assess and monitor the quality of care. The service encouraged feedback and used this to drive improvements. The provider aimed to provide people with high quality care.

Several people felt the service had improved recently and commented on the manager; “They sound very pro-active” and “They were very nice”. Staff told us they worked well as a team and found the manager approachable. One staff member said “They have an open door, no problems approaching them”.

You can see what action we told the provider to take at the back of the full version of the report.

11, 18, 19, 20 August 2014

During a routine inspection

This was a routine inspection to check that essential standards of quality and safety were being met. We also looked into concerns that had been raised.

We, the Care Quality Commission, received information of concern from people who used the service, their relatives, and Devon County Council's commissioning team. We received information that; medicines had been given in error and medication administration record (MAR) sheets were not available in people's homes; people had not received their visits as planned; the service had not been able to meet people's contracted hours of care; care plans were not in place or were not updated to reflect people's changed needs; and there was a lack of communication between the office and people who used the service.

Two adult social care inspectors carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

As part of this inspection we spoke with 19 people who used the service and their relatives and carried out three home visits. We sent out 61 surveys to people who used the service and their relatives. We received 38 completed surveys. We spoke with the agency's Managing Director, Operations Director, Deputy Operations Director, Recruitment Manager, Manager, and 11 staff. We spent two days at the agency's office. We reviewed records relating to the management of the service which included, six care plans, daily care records, medication records, and quality assurance records.

Below is a summary of what we found. The summary describes what people who used the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

Appropriate arrangements for recording and monitoring medicines were not in place. This meant people had been exposed to risks associated with unsafe administration of their medication.

The registered person did not have sufficient numbers of staff at all times to safeguard the health, safety and welfare of people who used the service. The service did not have sufficient staff to cover their contracted care hours. This meant people experienced late, cancelled and missed visits. The Operations Director told us they had handed back 600 care hours to Devon County Council. This meant the provider had taken action to try and ensure there were enough staff to cover visits.

Is the service effective?

Care plans were out of date as people's needs had changed. The agency had failed to assess people's changed needs to ensure care was delivered in line with their needs. This placed people at risk of unsafe care.

Visits weren't always allocated to ensure there was enough time for staff to travel between them. People were concerned about the timing of their visits. People commented 'you don't know who's coming or when'; 'I was going out and my visit was an hour and a half late so I had to cancel it'.

Is the service caring?

People who used the service told us they were happy with the staff who supported them with their care. Comments included 'They're all very nice and helpful'; 'Staff are as good as gold'; 'They know how to meet needs' and 'The carers are great. They come in, greet me, know what's required, and at the same time have a chat which is nice as I don't see many people'. When we spoke with staff it was clear they genuinely cared for the people they supported.

Is the service responsive?

Communication between the office and people who used the service was not always effective. People told us they left messages with the office but they didn't always get through. Comments included 'I have given up ringing the office' and 'they don't seem to communicate with each other'.

Communication between the office and the staff was not always effective. We found evidence that when staff had rung the office with concerns (about one person's medicine), concerns had not been logged on the system. This meant important information may not be logged and care may not be planned and delivered to meet people's needs and protect their welfare and safety.

Is the service well-led?

During this inspection, we identified shortfalls relating to care and welfare, management of medicines and staffing. During feedback at the end of the inspection, the Operations Director stated that they felt the shortfalls were 'A direct result of not having hands on manpower'. They told us they had already started work on making improvements. They confirmed that supervisors planned to review all care plans and time had been made available for this. We were informed of a number of recruitment strategies which were on-going to improve staffing levels.

1 October 2013

During a routine inspection

During our inspection, we visited the provider's office. We spoke with the managing director, manager, deputy manager, training manager, field manager, eight care workers and one healthcare professional. We spoke with 12 people who used the service and 6 relatives. We received 30 completed surveys; 21 from people who used the service and 9 from their relatives.

People we spoke with told us they felt that care workers treated them with respect, listened to them and respected their privacy and dignity. Comments included 'the carers are very respectful and I can't praise them enough' and 'the care is first class'.

Since the last inspection in February 2013, the service had reviewed and updated all the care plans. At this inspection, we found these contained enough information so that care workers knew how to support people.

People who used the service told us they were happy with the way staff supported them to take their medication. We saw there had been some medication errors. The provider had arranged further medication training for all care workers.

The service employed enough care workers to be able to cover all of their visits. There were systems in place to monitor the quality of the service provided.

13, 14 February 2013

During a routine inspection

On the day of our visit, the service was providing care to 693 people. People told us that staff were kind, listened to them and treated them with respect.

People who used the service told us they were happy with the care they received. They said 'they meet all of my care needs' and 'I'm very happy with the care'. We found some care plans contained a high level of detail so staff knew how to meet people's needs. Other care plans did not contain enough information for staff to know what to do. The agency had identified that care plans needed to be improved. They were in the process of introducing new care plans for each person who used the service.

People who used the service told us they were happy with the way staff supported them to take their medication. All staff had completed medication training. Records were in place to make sure people were protected.

Recruitment checks had been undertaken before staff began work to ensure people were supported by staff of suitable character and background. The agency had a comprehensive training programme. Staff told us they felt well supported in their job role.

Quality assurance systems were being developed to ensure the agency was able to assess and monitor the quality of the service. People who used the agency told us they were asked about the quality of the service. One person told us "when I raised a concern, they did something about it'.

3 November 2011

During a routine inspection

We (The Care Quality Commission) spoke to five people receiving care and three of their relatives. We also spoke to different types of staff including care workers, trainers, the registered manager and members of the executive team.

We spoke to a relative who said that ' All the girls are very nice and very obliging. A different care worker comes in every day but I think it's lovely as they all bring their own personality and chat away to my son.' The relative went on to describe the staff as 'very respectful and never overstepping the mark.'

One relative said 'the girls come on time and are always bright and cheerful.' She 'couldn't fault them' and said 'staff ask if they don't know anything.' She felt safe with the staff in her home and described them as 'like friends coming in.'

Another relative said that 'new people don't know what to do as the care is quite involved.' He felt the documentation 'was no help to them' and he had to tell staff what to do. Both the person receiving care and her relative said they felt safe and comfortable with different staff in their home. They had 'no problem at all and staff were very willing to help.'

One member of staff said ' they're a good company to work for ' they're so supportive.' Another member of staff described the quality of care as 'very high level.'