Archived: Community Care North East

Updated 28 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 17, 18, 20, 22, and 23 October 2017. The first day of our inspection was unannounced.

The inspection team consisted of one adult social care inspector.

Before we visited the service we checked the information we held about this location and the service provider, for example we looked at the inspection history, safeguarding notifications and complaints. A notification is information about important events which the service is required to send to the Commission by law. We also contacted professionals involved in caring for people who used the service; including local authority commissioners. Local authority commissioners told us they were carrying out monitoring visits to the service to ensure improvements were being made.

We did not ask the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used the opportunity of the inspection to explore the plans for the service with the registered manager.

During the inspection we spoke with three people who used the service and eight of their relatives. We reviewed 20 people’s care files and visited three people with their permission at their homes. We looked at five staff files and checked other records held by the service in the management of the regulated activity. We spoke with five staff including the registered manager, a senior carer, and two care staff members and an administrator.

Updated 28 December 2017

This comprehensive inspection took place on 17, 18, 20, 22, and 23 October 2017. The first day of the inspection was unannounced.

Community Care North East is registered with the Care Quality Commission to provide personal care in people’s own homes. The service is provided in County Durham and Gateshead. At the time of our inspection there were 37 people using the service, 3 of whom were in hospital.

At the last inspection carried out in June and July 2017 we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.The breaches were:-

Regulation 9 Person-centred care

Regulation 11 Need for consent

Regulation 12 Safe care and treatment

Regulation 16 Complaints

Regulation 17 Good governance

Regulation 18 Staffing

Regulation 19 Fit and proper persons employed

Following the inspection in June and July 2017 we rated the service as ‘Inadequate’ and the service was placed into ‘Special Measures’. The service had not been compliant with regulations since our inspection in March and April 2016. People who use adult social care services have the right to expect high-quality, safe, effective and compassionate care. Where care falls below this standard and is judged to be inadequate it is essential that the service improves quickly for the benefit of people who use it. Special measures will give people who use the service the reassurance that the care they get should improve.

Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements had been made and they are no longer rated as inadequate overall or in any of the key questions. Therefore, this service has now been taken out of Special Measures. We asked the provider to take action to make improvements. During this inspection we found no further regulatory breaches and no continued breaches of the regulations listed above.

There was a registered manager in post. 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.

Following our last inspection the provider had put in place an action plan to improve the service. We saw the provider and the registered manager had addressed the actions and progress had been made. For example, a timetable of unannounced spot checks on staff had been put in place and we saw the spot checks were being carried out.

Staff were supported through training, supervision and appraisal. Support was also provided to staff through regular meetings with the registered manager.

At our last inspection we found there were not enough staff on duty to cover the rota requirements and people complained to us staff were regularly late. The registered manager had used a local college’s recruitment days to attract prospective staff. They told us they had tried to recruit staff close to where people lived to reduce travelling time. They had recruited two staff however one had quickly left the service. During this inspection people told us sometimes staff were late but that was because of meeting the needs of other people prior to their visit. We saw work had begun on looking at rotas to enable staff had sufficient time to travel between visits.

When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with vulnerable people who needed care and support. New staff were required to undergo an induction process before they could work with people on their own.

People’s personal risk assessments had been updated together with their care plans. We found these had improved and were more person-centred. People’s relatives confirmed to us the information contained in the care plans and risk assessments was accurate. Staff completed daily notes to describe the care they had provided. We saw the notes corresponded with people’s care needs. A programme of three monthly reviews was in place to monitor people’s care plans.

The registered manager had taken action to improve the processes linked to the administration of people’s medicines. New medicine administration records (MAR) had been introduced into the service. The new MAR charts listed people’s topical medicines (creams applied to the skin) as well as their oral medicines.

Staff had been trained in safeguarding vulnerable people. Since our last inspection no safeguarding concerns had been raised with us.

The service had a weekly updates log in place, whereby office staff contacted the care staff for any updates about people’s changing care needs. Messages from relatives who contacted the service to say their family member had been admitted to, or discharged from hospital, were also documented. Staff had recorded how they handled this information and demonstrated good communication in the service.

We found the service had taken action to demonstrate they were complaint with the Mental Capacity Act 2005 and associated Code of Practice. Where people lacked capacity to make decisions the service had put in place best interest decisions following discussions with relatives to ensure people were protected. Consent had been obtained from people by the provider, to deliver people’s care. We saw people or their representative had signed people’s care plans.

People reported to us they found the staff to be caring and kind. Relatives told us staff worked with them and carried out their requests if they had to leave a note in their family member’s home to ask staff to carry out a task for their family member. People told us about how staff protected their dignity and privacy. Guidance to staff was written in people’s care plans to enable staff to support people to maintain their independence.

Since our last inspection there had been no complaints. People and their relatives told us they would contact the office to make a complaint.

The provider sent us the results of an updated survey used to monitor the service. The survey showed people were largely positive about the service.

At our last inspection we were concerned about staff accountability in relation to them arriving at and departing from people’s homes on time. The registered manager had introduced a paper based process so people could sign and confirm staff movements when they chose not to allow their home telephone number to be used for the provider’s electronic monitor system.

During this inspection we saw the service had made significant improvements. However, we found further time was needed to ensure the improvements could be sustained and embedded into the service provision.