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The provider of this service changed - see old profile

Reports


Inspection carried out on 18 December 2017

During a routine inspection

Inspection site visit activity started on 18 December 2017 and ended on 10 January 2018. There have not been any published inspection ratings for this service, as it was previously registered and run by a different provider. Under the previous registration the service was rated requires improvement with two breaches of regulation in relation to good governance and fit and proper persons employed. Although this is a new registration, this information is relevant because the current nominated individual for the registered provider and registered manager was also a director of the previous company and was responsible for its operation throughout.

Eldercare 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 people, some of whom are living with dementia. The service provides care and support to people living in Malton and surrounding areas. At the time of our inspection, there were 36 people using the service.

At the time of our inspection, the service had a registered manager. They had been the registered manager since August 2016. 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.

During this inspection, we found risk assessments were in place but not for all of the areas relevant to each person. Information contained in them was limited and did not provide sufficient details to enable staff to manage risks effectively. Medicines had not been administered as prescribed and staff had not received relevant training. Accidents and incidents had not been recorded accurately or monitored by the registered manager. People and staff told us they did not feel their confidentiality was respected.

This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 -Safe care and treatment.

Staff recruitment processes had not been followed. Applications did not contain full employment history, any gaps in employment had not been explored, interviews had not been recorded and references did not contain dates to evidence they had been received prior to employment commencing.

This was a breach of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 - Fit and proper persons employed.

Staff had not received training to ensure they had the skills and knowledge they needed to provide care and support to people. Regular supervisions and appraisals had not been conducted by management and staff told us they did not feel supported within their role.

This was a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 - Staffing.

Audits had not been completed to monitor and improve the quality of the service. Thorough, up to date records were not kept. Throughout the inspection we found a number of concerns that the registered manager was not aware of. We found people were at risk of harm because the registered provider and registered manager did not have systems or processes in place to ensure compliance with regulations.

This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 - Good governance .

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

Training records showed that not all staff had up to date safeguarding training. However, the staff we spoke with were able to described the different types of abuse and action they would take if they suspected abuse was taking place.

People consented to care and support from staff by verbally agreeing to it. Some care plan evidenced people had been involved in planning their care as signatures were present, but this was not consistent for everyone.

Care plans contained details of people’s nutritional preferences. However, we found that where fluid monitoring charts were in place for people who were at risk of dehydration, these were not always completed accurately to state the amount of fluid that had been given. There was evidence of working relationships with other professionals to maintain and promote people’s health. However, guidance provided had not always been followed.

People we spoke with told us that they were well cared for by staff and had no complaints with regards to their approach. All the people we spoke with said they felt staff treated them with dignity and respect.

Care plans did not always contain enough information to meet individual’s support needs and had not always been reviewed in a timely manner. Complaints had not always been fully recorded to evidence they had been responded to appropriately.

Regular staff meeting had taken place. However, staff told us the management team were not supportive or approachable. People who used the service had been asked to provide feedback.

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.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.