Archived: Cera Mill View

Allied Health-Services Limited Mill View is a domiciliary care agency that provides personal care to people living at an extra care housing scheme in Hauxton Cambridgeshire. The scheme consists of seventy, one- and two-bedroom flats, that can be purchased or rented. Each person's flat is provided with kitchen, lounge, bedroom[s] and a bathroom. The building, communal areas, flats and facilities such as the restaurant are run by a different organisation to the care service. Communal lounges, and dining facilities are provided within the scheme but were closed at the time of inspection, due to COVID-19. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. The service was providing personal care to 14 people at the time of the inspection.

People’s experience of using this service and what we found

During the COVID-19 pandemic, people, their relatives and the registered manager told us staff did not have access to face masks, that met the government guidelines, for two days as they had run out. Actions were taken to reduce the risk of recurrence, but some people and relatives told us that staff, when wearing face masks, did not always wear them correctly. This was seen during this inspection, although quickly rectified once noted. This demonstrated to us that the checks in place around safe infection control were still not robust enough.

People felt safe having their care provided by staff at the service and staff answering emergency call bells gave people reassurance. Risk assessments were in place to identify individual risks to people’s health and well-being. Measures were implemented to guide staff on how to reduce these risks. However, not all staff told us they had read this information, and this increased the risk of people receiving unsafe and ineffective care and support. Systems and checks were only now being introduced to ensure that staff were washing their hands during COVID-19, in line with their training, to reduce the risk of cross contamination. A new service manager had been recently recruited to ensure more day to day managerial oversight at this location. This was while the registered manager was not present as they were registered for two different services.

Audits were carried out to monitor the service and address any improvements required. However, the registered manager had not notified the CQC of two incidents that they were legally obliged to. One notification was received after the inspection

People and their relatives told us staff were usually punctual, but that their care call visits were sometimes cut short. This had been identified by an audit of people’s daily notes and staff had been spoken with to reduce the risk of recurrence.

Most people and their relatives had no concerns around the safe management of people’s medicines. Audits had identified that a new format medicines administration record would be clearer for staff and help reduce the risk of errors. People’s end of life wishes were not recorded.

There was a complaint process in place that was followed when a complaint or concern was raised. A concern raised again during the inspection was currently being relooked at by the registered manager.

Recruitment checks were completed to ensure staff were suitable to work with the people they supported. To develop their skills and knowledge staff received induction training, refresher training and supervisions. People were supported to maintain their independence.

Most people and their relatives told us staff promoted and maintained people's privacy and dignity. People and their relatives had mixed opinions of the standard of care they received. One relative confirmed that it depended on the staff member. This was fed back to the registered manager on inspection.

Staff worked in conjunction with guidance from external health and social care professionals across different organisations to help promote people's well-being. People’s personal information was kept confidential. People and their relatives were involved in discussions about their family members care and support needs. Staff felt well-supported.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

This service was registered with us on 5 August 2019 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about infection control, safe care and treatment and safe medicines management. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to regulation 12 (safe care and treatment) and regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.