Background to this inspection
Updated
15 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.
We made an announced inspection on 2 November 2017. The inspection team consisted of one Inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. They had knowledge and experience of care provided by domiciliary care agencies.
We gave the registered provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be available in the office.
Before the inspection, the provider completed 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. This information helped us to focus our inspection.
We looked at the information we held about the service and the provider. We asked the local authority if they had any information to share with us about the care provided by the service.
We spoke with 14 people who used the service and three relatives. We spoke with the area manager and the auditor/trainee manager. We also spoke with the office coordinator; two team leaders; and six care staff. We looked at eight care plans, which included risk assessments; initial assessments of needs; capacity assessments; healthcare information and reviews of people’s care. We looked at ten staff pre-employment files; medication audits; complaints and feedback received; safeguarding investigations; the provider's current action plan; and staff training records.
Updated
15 December 2017
Synergy Homecare is located in Stoke-on-Trent, Staffordshire The service provides personal care to people in their own homes, some of whom are living with dementia. On the day of our inspection, there were 73 people using the service.
The inspection took place on 2 November 2017 and was announced.
There was a registered manager at this service, but they were absent from work at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.
At our previous inspection on 16 and 17 May 2016, we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to consent; safe care and treatment; and good governance. The provider was issued with a warning notice in regard to these breaches, which specified they must comply with the Regulations. At this inspection, we found the provider remained in breach Regulation 17, good governance. Additional breaches of Regulation were also identified. These were in relation to receiving and acting on complaints, and notification of incidents.
The provider had not always followed their own recruitment process, which meant there was a risk of unsuitable people being employed to care for people.
There had been a recent period of three months where people's calls had been missed, or the carer had arrived late. Risk assessments were in place in relation to people's individual care and support needs, but more information was needed about how to keep people with certain conditions safe.
People's confidential care records were not always stored securely. Whilst there was a system in place for capturing feedback and complaints, these had not always been responded to or acted on.
Although staff were working within the requirements of the Mental Capacity Act, their knowledge and understanding of this key legislation was not at the necessary level.
The registered provider had investigated allegations of abuse and harm and informed the local authority, but had not informed the Care Quality Commission, as they were required to do.
Medication audits were regularly carried to ensure staff's practice was in keeping with current best practice and that people received their medicines safely and as prescribed.
There was consistency in regard to people's carers, with an understanding of the importance to people of having regular carers. People enjoyed positive and respectful relationships with staff.
People were supported to maintain their health and with their eating and drinking needs. Changes in people's health and wellbeing needs were responded to.
The provider ensured information was provided to people in a format which suited them. The provider showed regard for equality, diversity and human rights.
Staff felt supported in their roles and were enthusiastic about recent improvements and changes.
The provider's quality assurance systems had identified the current shortfalls in the service, and an action plan was in place to address these.