Archived: Professional Care Services

The inspection was completed on 16, 17 and 18 and 26 January 2017. At the time of the inspection there were 106 people who used the service.

A registered manager was in place at the time of the inspection but we were told that they had resigned. 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.

This inspection was bought forward from the planned date due to receiving concerns regarding staff leaving and also staff not being trained appropriately to carry out their roles.

The overall rating for this service is 'Inadequate' and the service is therefore in 'Special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

There was a lack of provider and managerial oversight of the service. Effective quality assurance checks were not in place to enable the provider to assess and monitor the service in line with regulatory requirements or to improve the quality and safety of the service. The provider’s arrangements were not robust as they had not recognised the issues we identified during our inspection. The systems in place to deal with comments and complaints required improvement as there was little evidence to show how actions, decisions and outcomes of concerns raised had been made. Improvements were required by the provider to ensure that all staff employed by the service received safeguarding training and suitable arrangements were in place to escalate concerns to the appropriate external agencies.

Proper recruitment checks had not been completed on all staff before they commenced working at the service and processes had not been operated in line with the provider’s own policy and procedures. Suitable arrangements were not in place to ensure that newly employed staff received suitable training opportunities, robust induction, formal supervision and an annual appraisal of their overall performance.

Suitable control measures were not put in place to mitigate risks or potential risk of harm for people using the service as steps to ensure people and others health and safety were not always considered and risk assessments had not been developed for all areas of identified risk.

Although People told us that they felt safe, staffing levels were not always suitable to meet people’s needs. People told us that there had been no missed calls, although there had been many occasions where staff were late. People received their medicines at the times they needed them although not all staff had undergone training to carry out this task.

Although staff delivering care were supporting people and was caring, the provider of the service was not acting in such a way that demonstrated that they cared about the wellbeing of the people they supported. This was because they did not ensure that the service was being delivered in such a way that ensured people’s safety and wellbeing.

People spoke positively about the way staff treated them and reported that they received appropriate care. Staff demonstrated a good knowledge and understanding of the people they cared for and supported. People told us that their personal care and support was provided in a way which maintained their privacy and dignity. However, we found that people’s care plans did not contain relevant and current information to guide staff on the most appropriate care people required to meet their needs.

In total we found breaches of seven Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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