20 January 2015
During a routine inspection
This inspection took place on Tuesday 20 January 2015 and was announced.
The agency Chorcare Ltd is managed from a domestic residence located in a residential area of Chorley. Services are provided to support people to live independently in the community and the range of support includes assistance with personal care, shopping, activities and appointments.
The service first registered with the Care Quality Commission (CQC) in April 2013 and was registered at a previous location address at the time of the last inspection on 14 August 2013. The service was compliant at that time with the areas looked at. In May 2014 the service moved and registered at its current location. This was the first inspection of the service since that change.
The provider has submitted an application to cancel the registration of Chorcare Ltd to provide the regulated activity of personal care since the inspection.
There was a registered manager in place. 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 told us contradictory things about the service they received. While people we spoke with were happy with the service provided, they were not happy about Chorcare Ltd who provided the service. Our own observations and the records we were able to look at did not always reflect the positive comments some people had made.
People told us there were enough staff to give them the support they needed and this was confirmed in our observations. However we found the provider had little involvement in this save for preparing rotas.
Staff knew from outside sources how to deal with and respond to incidents or allegations of abuse but no training in safeguarding adults had been provided by Chorcare Ltd.
Robust recruitment processes were not in place and staff had been sent out to work with vulnerable people without appropriate documentation and criminal records checks in place.
Staff were involved in the recording, storage and administration of medication for one person. Staff had received no training in medication management.
Staff told us they had received no induction and training. There were no induction or other training records available for staff currently employed by the service. Staff had not received any form of one to one supervision. This meant people could not be confident staff had the skills to meet their needs.
People’s safety was being compromised in a number of areas. Staff we spoke with were aware of the Mental Capacity Act 2005 (MCA) but were unable able to give us a good account of its principles. From conversations with people who received support from care staff employed by Chorcare Ltd we were happy that these principles were being applied however current staff had not received any training on the MCA or Deprivation of Liberty Safeguards (DoLS) via Chorcare Ltd.
People lived in their own homes and as such chose their own food and drinks. Staff we spoke with told us they would promote healthy eating and drinking. This was confirmed by people we spoke with but they would choose for themselves.
People spoke with were positive about the staff who worked with them. We were told they were friendly supportive and caring.
We looked at the one care plan in place at the time of the inspection and found it to be person centred and fully reflected the person’s needs. However we were informed that the registered manager had taken no part in compilation of this care plan, was not involved in this plan or associated records.
Leadership and management of the service was poor. There were no systems in place to effectively monitor the quality of the service or drive forward improvements. Although we were shown one survey of people who used Chorcare Ltd when there had been more people supported by them. The comments we saw were positive. We also found the provider had changed the name of his business and failed to notify CQC.
We found a significant number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in respect of staff recruitment, training and support, involvement in care planning for people as well as leadership.
We also identified breaches of the Care Quality Commission (Registration) Regulations 2009. As the provider had failed to notify us of significant events as required.
You can see what action we told the provider to take at the back of the full version of the report. We did not take formal enforcement action at this stage as the provider has submitted an application to cancel the registration of Chorcare Ltd to provide the regulated activity of personal care.