All inspections: Three Score Years & Ten

This inspection took place on 24 and 30 July 2015. The first day of the inspection was unannounced, so that the registered manager did not know we would be visiting. On the second day the registered manager knew that we would be returning to complete the inspection. At the time of our inspection one person was receiving personal care [the regulated activity].

Three Score Years & Ten provide a range of support services, including personal care in people’s own homes [the regulated activity], cleaning, a gardening and handyman service, befriending and advocacy. Support is provided to people living in the Stockton area. The office is located centrally on Yarm Road and is on the ground floor, with parking available outside.

The service has a registered manager, who has been registered with us in respect of this service since 16 April 2012. 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.

Staff were aware of safeguarding procedures and could describe what they would do if they thought somebody was being mistreated, but safeguarding procedures needed to be updated and some staff hadn’t received training on abuse and safeguarding.

At our last inspection we had asked the registered provider to make improvements to the way staff were recruited. At this inspection we found that safe arrangements were in place for staff recruitment and that enough staff were available to provide people’s care. The person who used the service told us that they had a small and consistent staff team visiting them and that the staff were reliable.

The service had health and safety related procedures, including systems for reporting and recording accidents and incidents. The care records we looked at included risk assessments, which had been completed to identify any risks associated with delivering the person’s care. However, staff reported that safety related systems for protecting staff did not always work effectively. For example, a lack of checks to ensure that lone workers were safe at the end of their working shift and an emergency ‘on call’ system that did not always result in prompt assistance being available to staff when needed.

Procedures were in place for assisting people with medicines, but the service was not helping anyone with medicines at the time of our visit. The registered manager informed us that they did not intend to provide help with medicines again in the future.

People were not always cared for by staff who were appropriately supported or provided with appropriate training. However, the person who used the service told us that their staff were competent and knew what was expected of them. Staff told us they did not always feel well supported by their management.

This service supports people in their own homes and only provides help with meal preparation and eating and drinking where this has been agreed as part of the person’s individual care plan. We saw that information about the help someone needed with meal preparation, eating and drinking was included in their care plans where this was appropriate.

The staff we spoke with could describe what they would do if someone was unwell or needed medical support during a care visit.

The person who used the service told us that staff were caring, treated them well, respected their privacy and encouraged their independence. Staff were able to describe how they worked to maintained people’s privacy and independence.

People’s care records showed that their needs had been planned in a person centred way. The person who used the service told us that they were involved in setting up their care, but had not been involved in any formal reviews. The person using the service told us that any requested changes to their care, such as cancellations or changes to times, had been made appropriately.

The person who used the service had written information about the formal complaints process available in their care file. Records showed that complaints had been investigated and responded to personally by the registered manager.

The person using the service told us that they were happy with their care and sad that the company had decided to cease providing a personal care service.

Effective governance systems were not in place and the required records were not always maintained or available. Overall we found that the service was not always well led and that management systems were not always fully in place or robust.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Our inspection team was made up of one inspector. We gathered evidence against the outcomes we inspected to help answer the five key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

We looked at a range of records, spoke with the manager and four staff. We also spoke with five people who used the service or their relatives where appropriate.

Below is a summary of what we found. The summary is based on our observations during the inspection and speaking with the people who used the service and staff.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People's care needs had been assessed and planned. This meant that information was available to staff about people's needs and how care should be provided to keep people safe. This helped to ensure that people were kept safe and received the care they needed.

Improvements had been made to the training and support that was provided to staff. This helped to ensure that staff provided care safely and in accordance with the organisations procedures.

However, there remained improvements to be made to the way the service recruits staff. For example, staff understanding around the requirements for new DBS checks and the rules around their portability. This is important to ensure that people are protected from potentially unsuitable staff.

Is it effective?

People told us that they received the care that had been agreed and were generally happy with the way their service was provided.

Is it caring?

People told us that their carers were reliable, caring and treated them well. People also told us that the management were approachable, well-meaning and tried to resolve any difficulties that arose.

Is it responsive?

Improvements had been made since our last visit, although staff had not always accessed or understood appropriate guidance to ensure that they were meeting regulatory requirements.

Staff were able to demonstrate the changes they had made as a result of feedback from people who used the service and staff. This included changes on an individual level involving people who used the service and how their care was delivered.

It is well led?

The service had a registered manager. Staff had tried hard to make changes and wanted to provide people with the best service they could. There were now checks in place to help monitor the quality of the service that was being provided.

Feedback we received from staff and people who used the service suggested that management were well meaning, willing to listen and tried to address any issues brought to their attention. However, some people felt that they didn't always see things through or resolve things effectively, which could be frustrating.

New administration and supervisory staff had recently been recruited and a new staff structure had been put in place, to delegate management responsibilities and help make the service's management and development more effective.

What people told us:

During this inspection we spoke to people who used the service, their relatives and staff.

People told us that they received the care that had been agreed and that the service met their needs. Comments made to us about people's care included 'I get the same girls, this is a good thing because you get to know them and they get to know you' and 'I would recommend them to other people.' Comments made to us about the service's staff included 'Very courteous and willing to do whatever needs doing' and 'They all seem to be pretty good.'

At the time of the inspection this domiciliary care agency provided care and support to six people aged 18 and above. As part of the inspection we spoke with two people who used the service and one relative. We also spoke with three staff, a care co-ordinator and a manager.

Two people we spoke with and one relative all confirmed they were happy with the care and support provided. One person told us, 'This is a top class care company. They are very good throughout.'

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People who used the service and relatives were aware of who to speak with should they need to raise a concern in relation to abuse. One person we spoke with told us they had raised a concern with the manager and they felt that the manager acted appropriately. They told us they were happy with the outcome.

Appropriate checks were not carried out on staff before they started work to make sure they were fit to work with vulnerable adults.

The provider had no systems in place to ensure the quality of the service.

Archived: Three Score Years & Ten

All Inspections

24 & 30 July 2015

During a routine inspection

21 May 2014

During a routine inspection

6, 7 January 2014

During a routine inspection