Fosse Healthcare – Nottinghamshire is a domiciliary care agency providing personal care to 301 people across Nottinghamshire. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.People’s experience of using this service and what we found
People told us they felt safe with staff; however, many raised concerns about staff punctuality and the consistency of staff. Records showed calls were overall made on time and people normally received a consistent team of staff; however, people told us their experiences did not always reflect this.
Risks were assessed in key areas; although, this was not consistently applied across all aspects of care, such as repositioning of people who were at risk of developing pressure sores. Environmental risk assessments were in place, but these did not include reference as to how to make people safe in an emergency.
The provider ensured safeguarding processes were followed. People’s medicines were managed safely. The risk of the spread of infection was safely managed.
The provider had systems in place to help staff to learn from mistakes. We did note that a staff member did not follow care plan and risk assessment guidance when providing care for a person which placed the person’s safety at risk.
Most people received care in line with their assessed needs. There were gaps in some staff training, although there were plans in place to address this.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.
People received the support they needed to maintain a healthy diet, although guidance was not in place to support people with appropriate foods for a diabetic diet. People had access to other health and social care agencies where needed.
People and relatives found the staff to be caring and respectful. People were treated with dignity when personal care was provided. Independence was encouraged.
People felt involved with decisions and that staff respected their wishes. People’s records were stored securely to protect their privacy.
People’s care records were person-centred and focused on what was important to them. People told us when they received their expected member(s) of staff they always received care in their preferred way.
Complaints were responded to in line with the provider’s complaints policy. People were not currently receiving end of life care. End of life care was to be discussed with people during reviews of their care.
Quality assurance processes were in place; however, these were not always effective in highlighting and addressing the concerns we have raised during this inspection.
Some members of staff had not completed refresher training when needed, this could place people at risk of receiving inappropriate or unsafe care.
People were asked for their views during telephone interviews; however, no analysis was conducted to identify any trends. No annual survey was completed to enable the provider to assess the quality of the service provided for all. This could hinder the opportunity for continued learning and development.
Some people felt office-based staff did not always communicate effectively with them. When people had met the registered manager, they found her to be supportive and approachable. The registered manager had a good understanding of the regulatory requirements of their role
Rating at last inspection and update: The last rating for this service was Good (published 7 March 2017). The service’s rating has now changed to requires improvement.
We have identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. More information about this is in the full report and can also be found at www.cqc.org.uk
Why we inspected
This was a planned inspection based on the previous rating
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.