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Archived: ICare Solutions Manchester Limited Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 26 April 2017

We inspected ICare Solutions Manchester on 12, 16 and 20 December 2016. The first day of inspection was unannounced. The second day was spent visiting people in their homes who received a service and the third was spent back in the office providing feedback to management.

ICare Solutions is a domiciliary care service providing personal care and support to people living in their own homes. The service also works closely with healthcare commissioning teams in supporting people who have a range of healthcare needs. The hours of support vary depending on the assessed needs of people.

At the time of the inspection the service was supporting 75 people within the local community of Manchester and Stockport. We last inspected the service on 1 May 2014 when we found the provider was non-compliant in Regulation 12 of the Health and Social Care Act 2008.

There was a registered manager in post. 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 they received safe care, which was reliable and consistent. The service had sufficient staff to meet people’s needs, and people were given the time they needed to ensure their care needs were met.

We saw that people were protected from avoidable harm. During the inspection we checked to see how the service protected vulnerable people against abuse and if staff knew what to do if they suspected abuse. There was an up to date safeguarding vulnerable adult’s policy in place. Risks to people were assessed and risk management plans were in place. We found that the staff we spoke with had a good knowledge of the principles of safeguarding.

Risks posed to people were identified during the assessment process. Care plans we looked at contained information in relation to risks that had been identified for individuals, for example when mobilising or having medicines. Environmental risks had also been identified and documented for staff.

Staff were trained to administer medicines. The registered manager was in the process of implementing a more thorough Medication Administration Record (MAR) chart for more accurate recording of medicines. The management team acknowledged that the medicines management system could be more robust and agreed to re-visit their policy, ensure this was aligned to best practice and implement any changes they needed to make the system safer.

The service was not working to the principles of the Mental Capacity Act, 2005 and staff did not receive any formal training on MCA. The service was not assessing and documenting, where necessary, people’s ability to consent to care.

The service had robust recruitment processes which included the completion of pre-employment checks prior to a new member of staff working at the service. This helped to ensure that staff members employed to support people were suitable and fit to do so. People who used the service could be confident that they were protected from staff that were known to be unsuitable to work with vulnerable people. Staff knew their roles and responsibilities and were knowledgeable about the risks of abuse and reporting procedures.

We saw evidence of the induction process and there was on going training provided for caring roles and responsibilities.

People were supported with a range of services which enabled them to continue to live in their own homes safely. People we spoke with who used the service and their relatives told us they had been involved in the assessment and planning of the care and support provided and that the service responded to changes in people’s needs.

The care records contained information about the support people required. We saw documented evidence of people’s likes, dislikes and preferences and records we saw were complete and up to date.

We found from looking at people’s care records that the service liaised with health and social care professionals involved in people’s care if their health or support needs changed. The service worked alongside other professionals and agencies in order to meet people’s care requirements.

Likes, dislikes and personal preferences of people using the service were documented in care plans. People had been consulted and the service recognised the importance of documenting this information so that care and support provided was personalised, safe and correct for the individual.

There was an up to date accident/ incident policy and procedure in place. Records of accidents and incidents were recorded by care workers within communication books, however these were not always actioned at the office. The recording of accidents and incidents needed formalising.

The service had a complaints policy in place and we could see that people using the service were aware of how to make a complaint. Formal complaints were acknowledged and addressed within specified timescales.

Staff told us they felt they were able to put their views across to senior staff and to management and we saw examples of this from minutes of meetings and supervision records. The staff we spoke with told us they enjoyed working at the service and said they felt fully supported and listened to.

The service did not undertake spot checks on staff to observe behaviour and practice and the formal audits in place to monitor the quality of service delivery were not limited and ineffective. Feedback from people using the service and their relatives was gained via various sources. The service could evidence that it had acted on feedback to improve the care experience for people.

The overall rating for this service is ‘requires improvement’. During this inspection we found two breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Requires improvement

Updated 26 April 2017

The service was not always safe

Accidents and incidents were recorded by care workers. It was not always clear if these had been reported to the office and whether any further action had been taken.

Staff were able to describe the action they would take to protect people if they were concerned people were at risk of harm or abuse.

Medicines were being administered according to company policy. However, we found instances where the medication administration record had not been completed, to indicate medicines had been safely administered. A more robust document for recording medicines administered was being rolled out by the company.

Effective

Requires improvement

Updated 26 April 2017

The service was not always effective.

The principles of the Mental Capacity Act 2005 were not being followed. There were no capacity assessments on care plans and consent to care was not managed appropriately.

Staff received mandatory training in relevant aspects prior to starting employment.

Supervision was consistent for all staff. Staff were given the opportunity to raise any concerns about individuals they were supporting.

Caring

Good

Updated 26 April 2017

The service was caring

People and their relatives told us they were supported by staff who understood their needs.

Care staff we spoke with demonstrated their understanding of how to maintain people’s privacy and promote dignity.

People were encouraged to maintain their independence.

Responsive

Good

Updated 26 April 2017

The service was responsive.

The provider delivered care that was responsive to people’s individual personal preferences.

The service was flexible and responsive to people’s individual requests.

Complaints and concerns had been investigated and resolved to people’s satisfaction.

Well-led

Requires improvement

Updated 26 April 2017

The service was not always well led.

The system of quality checks and audits in place was ineffective therefore improvements were not always identified or implemented.

Staff felt supported by the registered manager and they felt listened to.

The service had a positive culture and wanted to develop. Feedback from people using the service and their relatives provided evidence of improvements the service had made.