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Cambridge Care Company - Haverhill Requires improvement

This service was previously registered at a different address - see old profile

The provider of this service has requested a review of one or more of the ratings.

Reports


Inspection carried out on 2 October 2017

During an inspection to make sure that the improvements required had been made

We carried out an announced comprehensive inspection of this service between 7 March 2017 and 28 April 2017. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to Regulation 18 on staffing and Regulation 12 medicines.

We undertook this unannounced focused inspection on 2 October 2017 to check that they had followed their plan and to confirm that they now met legal requirements. We also telephoned people over the next three days and awaited further information from the provider that arrived on 18 October 2017. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Cambridge Care Haverhill on our website at www.cqc.org.uk.

We had been contacted by people’s representatives who used the service and staff who worked for Cambridge Care who shared concerns about care delivery. The team inspected the service against one of the five questions we ask about services: is the service safe.

No risks, concerns or significant improvement were identified in the remaining Key Questions through our on going monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults, younger disabled adults and supported living for adults with a learning disability. This inspection focused upon Haverhill and we were told that they provide approximately 1300 hours per week to 100 people. As well as staffing two bungalows 24 hours for adults with a learning disability.

The service had an appointed manager in post that was in the process of applying to become registered with the CQC as the registered manager of the Haverhill location. 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 previous inspection there was a breach in staffing because there was not always enough staff deployed in a timely manner. This remained the same at this inspection. People told us they were generally happy with the service, but people could not rely upon Cambridge Care to meet their needs when they needed them met. People experienced an inconsistent service delivery with staff changes made that led people to experience a service that was well meaning but erratic for some people. Therefore we have found an on going breach of regulation because the service did not have sufficient staff to keep people safe and meet their needs.

At the previous inspection we found a failure to manage people's medicines safely and the inadequate risk management placed people at risk of harm. At this inspection some people fed back they were generally satisfied others were deeply unsatisfied and said people were at risk when they did not receive their medicines. We found that medicines were not safely managed. Staff had not consistently followed policy and procedure when a prescriber of medicines verbally communicated a change in amounts of medicines to be administered. Nor had they been given written instruction when medicines needed specific administration methods. Audits were not consistent an thorough. But of concern was that some important medicines had gone missing. We did not see that an investigation and report into the matter had been conducted to learn from the events to ensure all concerned learnt from the incident. Therefore we have found an ongoing breach of regulation because medicines were not as safely managed as they should be.

We found a breach in regulation relating to the assessment of risks and the actions taken to mitigate these and keep people safe. This was because peoples risk assessments were not individualised and specific to the person and did not always adequately inform staff on how to keep a person safe. Examples we have used relates to a moving and handling assessment that was inadequate and left both the person and safe at potential risk. People were not consistently protected from issues relating to infection control.

We found a breach relating to safeguarding people from abuse and improper treatment because systems and processes were not effective to investigate, immediately upon becoming aware of any allegation or evidence of abuse.

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