Archived: Fosse Healthcare - Leicester

This is the second comprehensive inspection of the service. This inspection took place on 1, 2, 7 and 22 August 2018 and was announced. At the time of our inspection visit 180 people were using the service.

At our last inspection in May 2017 we rated the service overall as ‘Requires Improvement’. At this inspection the service had improved, we found evidence to support the rating of Good.

The service did not yet have a registered manager the current manager has begun the registration process. 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 were protected from the risk of harm. Staff had been trained in safeguarding people and understood how to assess, monitor and manage their safety. A range of risk assessments were completed and preventative action was taken to reduce the risk of harm to people.

People were supported with their medicines in a safe way. People’s nutritional needs were met and they were supported with their health care needs when required. The service worked with other organisations to ensure that people received coordinated care and support.

People were protected by safe recruitment procedures to help ensure staff were suitable to work in care services. There were enough staff to meet people's needs. Staff received training for their role and ongoing support and supervision to work effectively.

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 supported this practice. The provider followed the principles of the Mental Capacity Act, 2005 (MCA) in planning and delivering people's support. People's consent was obtained before they were supported.

People and where appropriate their relatives were involved in planning peoples care. Care plans were reviewed and updated as people’s needs changed. Staff were provided with clear guidance to follow in the care plan which included information about people’s preferences, daily routines and diverse cultural needs. Staff had a good understanding of people's needs and preferences and worked flexibly to ensure they were responsive.

Most of the people and their relatives were happy with staff who provided people’s personal care and had developed positive trusting relationships.

People, relatives and staff were encouraged to provide feedback about the service which was used to assess the quality of the service and to make any required improvements. The provider had a process in place which ensured people could raise any complaints or concerns and people felt comfortable to do this should they need to.

The manager and staff team were committed to the provider’s vision and values of providing good quality, person centred care. The provider’s quality assurance system to monitor and assess the quality of the service was used effectively to improve the service. Lessons were learnt when things went wrong and improvements made to prevent it happening again. The provider worked in partnership with other agencies to meet people’s needs and people's health and well-being was continuously monitored by the staff.

At the previous location we carried out an announced full comprehensive inspection of the service on 9 and 15 December 2016. We found breaches of two regulations and issued the provider with warning notices in relation to governance and person centred care at the service. At this inspection we found that the provider had made a number of improvements to the service but we still identified concerns in relation to the governance of the service.

The service is a domiciliary care agency that provides personal care to people in their own homes. At the time of our inspection103 people used the service.

The service had a registered manager. 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 and their relatives told us that they felt safe. Risk associated with activities of people’s care had been assessed and measures were in place to prevent avoidable harm. The environment and equipment was checked and maintained in order to keep people safe.

Staff were aware of their responsibility to keep people safe from avoidable harm. Safe recruitment practices were followed. Staff felt able to recognise and report as safeguarding concerns.

There were not always enough staff to meet people’s needs. People could not be assured that they would receive their care calls at the agreed times.

Staff had received training and supervision to meet the needs of the people who used the service. Their practice was checked to ensure that they were competent in their roles. Staff told us that they felt supported.

People received their medicines as required. Medicines were administered safely by staff who were appropriately trained and competent to do so. Records relating to people medicines were checked to ensure that staff had followed the prescriber’s guidance.

People’s health needs were met and when necessary, outside health professionals were contacted for support. People were supported to have enough to eat and drink.

People were not supported in line with the requirements of the Mental Capacity Act (MCA). Where people were suspected of lacking the capacity to make decisions for themselves assessments had not been taken to confirm this.

People were supported by staff who understood that they should be treated with dignity and respect. However some people felt that staff rushed their care and did not take the time they needed with them. People’s independence was promoted and encouraged.

People were involved in planning and reviewing their care. People did not always receive the care that they had agreed. Staff understood their role and how to support people as individuals. People did not always receive support from staff who they were familiar with.

People had been asked for feedback about the service. People felt that the service had improved however there were still areas to be addressed. The registered manager was taking action to address the areas of concern. The provider had an effective system for dealing with complaints.

Staff were clear on their role, the expectations of them and the aims and objectives of the service. Staff felt supported however they felt that communication between them and the office staff required improvement.

Systems were in place to monitor the quality of the service being provided and drive improvement. When concerns had been identified these had been addressed. However the provider did not have an effective system to monitor the times that staff supported people. They could not be assured that people received their care when they should.

The registered manager was aware of their responsibility to report events that occurred within the service to CQC and external agencies.

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