Archived: Caring First Limited

In January 2014, the Care Quality Commission issued three compliance actions to the registered persons regarding them not taking appropriate steps to ensure people were protected against the risk of receiving poor care; not having satisfactory systems in place for monitoring the service delivered to people was effective; and not ensuring satisfactory records systems were in place.

This inspection was completed to check suitable action had been taken to improve standards regarding the care and welfare of people who use the service, quality assurance procedures and record keeping.

Subsequently at this responsive inspection we wanted to answer the questions whether the service was now safe and well led.

During the inspection we were able to speak with 27 people who used the service and /or their relatives. We spoke with 6 of these people at their homes, and the other people we spoke with by telephone. We were able to speak also to 8 care staff who worked for the agency.

Below is a summary of what we found.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

No, as a consequence of this inspection, we judged the service was potentially not safe due to some people not always receiving care at times previously agreed with them and sometimes to a standard they expected.

The majority of people we spoke with said they were happy with their care. For example comments included 'it has been great....the staff are as good as gold,' and 'excellent.' However there was significant number of people who felt their experience should be improved. For example people told us 'they are never on time, they give me a time but never keep to it,' 'time keeping is very erratic,' and 'it could be better, staff do not read the care plan, they have a general gist of what needs doing but they will do things their own way'.sometimes they are not that careful.'

Several members of staff and people who used the service said travel time was not built into staff schedules. Some people said this resulted in staff being late, rushed, or leaving visits early in order to get to the next visit at a reasonable time. This was deemed by some of the people we spoke with to have a negative impact on their care.

Is the service well led?

No, as a consequence of this inspection we judged the service was not well led.

We checked what systems the organisation had in place to monitor the service was effective, and to ensure any risks were minimised. The service had a satisfactory quality assurance policy, and there were comprehensive systems in place to monitor the service. However based upon the feedback received from staff and people who used the service, there were problems with the organisation detecting and putting right problems which some people told us they experienced. There had also been insufficient action to improve certain aspects of the service, for example to ensure people received their care at the times allocated to them. This matter had been previously highlighted in our report dated January 2014.

However we concluded overall the registered provider had taken appropriate action to monitor and improve record keeping. This matter had been highlighted at our inspection in January 2014.

Most people told us that they received good care. However some people told us that they did not always receive care at the time they were expecting and that on occasions, one member of staff did not turn up which meant that they were only had one member of staff to help them get up or move around. This put the person at risk of falling.

We found that staff had regular supervision and appraisals. Staff received an induction when they joined which included attendance at training courses and shadowing other staff. Staff also received regular refresher training and were supported to gain additional relevant qualifications.

The provider had some systems in place to monitor the quality of services provided, which included annual audits, telephone reviews with people and monthly reports for stakeholder organisations. However, they did not have adequate systems to fully quality assure the care delivered.

The provider had systems in place for the safe storage of records. There was evidence that staff records were maintained and managed appropriately. However, there was some evidence that some people's records were not accurate and complete, which could lead to incorrect care being provided.

We found, people's views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People's privacy, dignity and independence were respected and people experienced care, treatment and support that met their needs and protected their rights.

We found that, people who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We saw that there were appropriate checks undertaken before staff began work and that there was an effective complaints system available. Comments and complaints that people made were responded to appropriately.

However, people were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.