Archived: SSA Social Care and Community Services

SSA Social Care and Community Services provide personal care to people living in their own homes. The agency has an office in the Burngreave area of Sheffield. SSA Social Care and Community Services support people with a wide range of needs. At the time of our inspection there were 43 people receiving personal care from the service.

At the time of our inspection the service had 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.

The service had a policy in place to safeguard people from abuse. This included the types of abuse and how to recognise abuse. It also gave guidance to staff about how to report any concerns. Staff we spoke with told us they had received training in safeguarding and that this was repeated on an annual basis.

We looked at systems in place to manage people’s medicines in a safe way. We saw medication administration records (MARs) were completed, but noted that gaps in recording were evident. We viewed the medication policy and found that this contradicted what happened in practice.

We looked at care plans belonging to people who used the service and found they identified risks associated with people’s care. For example moving and handling.

The service had a staff recruitment system in place to ensure the people employed were safe and suitable for the role they applied for. Pre-employment checks were obtained prior to people commencing employment.

We spoke with staff who told us they received training mainly via the use of videos which they watched and then had a series of questions to answer about the subject.

We were not assured that staff received adequate training solely through watching videos and answering questions as this would not give them the practical knowledge and practice required for some aspects of training such as moving and handling.

We found the service to be meeting the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).

We looked at care plans which contained information about the person’s capacity. We saw that mental capacity assessments and best interest decisions had been made where people lacked capacity to make a decision.

We spoke with people who used the service and looked at their support plans and found that support plans clearly identified the nutritional support people required.

People were supported to maintain good health, have access to healthcare services and received ongoing healthcare support. We looked at people’s records and found they had received support from healthcare professionals when required.

We looked at a selection of care plans and found they included information regarding people’s likes and dislikes. Staff we spoke with knew how to maintain people’s privacy and dignity.

People’s needs were assessed and care and support was planned and delivered in line with their individual care plan. We looked at a selection of care plans and found they included the desired outcomes for the person.

The service had a complaints procedure in place and the company welcomed them as an opportunity to learn, adapt, improve and provide a better service. The provider encourages concerns and felt they should be dealt with properly and effectively so that people felt confident that their concerns were listened to and acted upon.

We saw audits had been completed to ensure policies and procedures were being followed. However, there was limited information recorded as to what the outcome of the audit was and what action was taken when required. We also found that some policies required updating to reflect current practice within the organisation.

Staff we spoke with felt the service was well led and the registered manager was approachable and listened to them. Staff confirmed they knew their role within the organisation and the role of others. They knew what was expected of them and took accountability at their level.

An adult social care inspector carried out this inspection. We considered all the evidence we had gathered against the outcomes we inspected in order to answer our five key questions; is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led? Below is a summary of what we found. The summary incorporates what people using the service, their relatives and the staff told us, what we observed and the records we looked at -

- Is the service safe?

People told us that they felt, 'safe' when being supported by support workers from SSA Social Care and Community Services.

We spoke with three support workers about the Mental Capacity Act 2005. The MCA provides a framework to empower and protect people who may lack capacity to make key decisions about their care and treatment. Two of the three support workers we spoke with were unaware of the MCA and the importance of this within their work. Knowledge of the Act is key to ensure that staff are able to appropriately safeguard people by identifying the need for further assessment and support about the key decisions covered by the Act.

Our review of records identified that SSA Social Care and Community Services did not have a MCA policy or procedure. The registered manager confirmed this and agreed to put these documents in place.

People who received support with their personal care needs told us that the support workers wore gloves and also washed their hands prior to and after supporting them to minimise the spread of infection. Each member of staff was to describe good hand hygiene and the importance of this, as well as how they reduced the spread of infection.

Our spot visit to the home of one person and information gained after our inspection visit, identified that support workers were not always wearing aprons to safely control and minimise the spread of infection when supporting people. The adult care coordinator also identified this and informed us of her intention to e-mail all staff to remind them of the importance of wearing aprons.

We found that SSA Social Care and Community Services had an effective process in place to ensure that employees were of good character and held the necessary checks, skills and qualifications needed to provide safe and effective care to people.

-Is the service effective?

Our conversations with people and our review of care plans showed us that care and treatment had been planned and delivered in a way that was intended to ensure people's safety and welfare.

Each care plan reviewed during our inspection was comprehensive and reflected current good practice guidance about person centred, outcome focussed care. This was demonstrated by each plan including person centred information about people's individual needs, how they liked to be supported and the outcome to be achieved. The person visited on the day of our inspection was positive about the care plan in place. They told us that they had been involved in the writing of their care plan and described it as, 'very detailed'.

People told us that support workers from SSA Social Care and Community Services always spent the allocated period of time with them and were rarely late. People were also appreciative of the fact that they were supported by consistent teams of support workers.

-Is the service caring?

We received positive feedback about SSA Social Care and Community Services from each person contacted during the course of our inspection. The person visited on the day of our inspection described the support they received as, 'very good and thorough'. Other positive comments received from people included, 'everything is perfect', 'the support workers are all good and do their job well', 'they [SSA Social Care and Community Services] are a brilliant company, they give me what I personally need. I really recommend them', and 'the support workers are polite, hardworking and good.

-Is the service responsive?

Our conversations with people provided evidence of various ways in which SSA Social Care and Community Services responded to people's needs and individual requests. For example, a number of people were particularly positive about the flexibility of the support and the impact this had upon their wellbeing. One person told us that support workers agreeing to undertake a late evening call had enabled them to spend an evening out with friends, something they had not been able to do for a while.

One person told us that there had been some compatibility issues with one of their support workers. They told us that they contacted the provider and this resulted in a more suitable support worker being found. This showed us that SSA Social Care and Community Services responded quickly to meet people's individual needs and requests.

-Is the service well led?

We found that SSA Social Care and Community Support had effective systems to assess and monitor the quality of the service they provided.

We accompanied the adult care coordinator on a spot check visit to the home of a person supported by SSA Social Care and Community Services. The adult care coordinator asked this person and their spouse questions about a range of relevant areas. The person and their spouse described the service provided by SSA Social Care and Community Services as, 'absolutely fantastic'.

We saw copies of completed spot checks within people's care plan files. The records of these checks were detailed and recognised areas of good practice as well as areas for improvement. This demonstrated the provider's commitment to continually improve the service people received from SSA Social Care and Community Services.

The registered manager told us that they were able to extract information about the quality of key elements of the service from 'People Planner', their electronic database. For example, the time which support workers spent at people's homes was monitored by them dialling into this software when they arrived and left people's homes. The registered manager told us they were able to run reports to see if support workers were arriving on time and staying for the required amount of time.

We received mixed responses from staff about staff meetings. Some members of staff told us that they were not aware of staff meetings, whilst another member of staff told us that they had not attended a meeting for a number of years. The registered manager confirmed that a staff meeting had not taken place for a number of months and told us that staff received updates about the service through a regular newsletter. We requested a copy of the most recent newsletter; this had been produced in April 2013.

Whilst staff spoken with on the day of our inspection felt that communication with the management team was good, frequent meetings and other forms of communication are essential. Such meeting ensure that key information from all aspects of the service is gathered and shared in order to continually improve the service and reduce the risk of unsafe care and support.

We found that SSA Social Care and Community Services had not received any complaints within the past twelve months. Our conversations with people and relatives, together with our review of records confirmed that people were happy with the service provided.

Our conversations with people supported by SSA Social Care & Community Services identified that the agency maintained people's dignity, privacy and respected people's individual choices. One person described their support worker as, 'pleasant, polite and charming.'

People were positive about the support they received from the agency. One person said 'I've never had any problems with the company or with individual workers.'

Each person spoken with as part of our inspection said that they felt safe when being supported by members of care staff from SSA Social Care & Community Services . Our conversations staff and our check of records demonstrated that the agency were aware of, and followed local safeguarding procedures in order to safeguard the people they supported.

We found that most staff received supervision and an annual appraisal within the providers identified timescales. We also noted that staff received a range of training courses and were given opportunities to undertake further training.

We saw that SSA Social Care & Community Services had appropriate systems to gather, record and evaluate the quality and safety of care provided.