26 August 2016
During a routine inspection
All Seasons is based in the Garforth area of Leeds. The agency provides personal care and support to people living in their own homes.
At the time of our inspection the service had a registered provider, although they did not have a registered manager. 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 and associated Regulations about how the service is run.
The inspection concluded the administration of medicines was not always safe as staff competency checks had not been carried out. Protocols for ‘as and when required’ (PRN) medicines were not in place and we found some gaps in the recording on medication administration records, although a sample of daily notes showed some of these visits had been cancelled.
Staff had an understanding of the Mental Capacity Act 2005 (MCA) and the responsibilities this placed on them. The registered provider had made referrals to the local authority regarding MCA assessments. We recommended the registered provider formalise these records in people’s care and support plans.
Staff did not receive supervisions and appraisals in line with the registered provider’s policy, although staff felt they were adequately supported by the manager who was approachable and familiar with people who received this service.
Recruitment practices were not always safe as one member of staff had been allowed to commence work with a DBS dated May 2012 and no last employer reference.
People felt safe receiving this service and we saw risks had been appropriately assessed. People were confident they received care and support from a staff team who had been adequately trained and were familiar with their needs. People and relatives were satisfied that staff worked at their pace and ensured they were able to maintain their privacy and dignity.
People and their relatives had been involved in creating their care plans which were detailed and person-centred. Staff were satisfied they accurately represented people’s care and support needs, although we saw some updates were required. Reviews of care plans were taking place on a regular basis.
There were no outstanding complaints at the time of our inspection. People had been given information which enabled them to complain in the event they were unhappy with the service they received. A recent satisfaction survey contained positive feedback from people who received this service. The manager had formally contacted people who raised any concerns.
Staff were allocated sufficient travel times between their calls and the registered provider and manager covered for any emergencies or staff absences. Visits were usually on time and no one reported experiencing a missed visit.
People were supported by staff to access the local community and appropriate referrals to healthcare professionals had been made. People were supported by staff who ensured they had enough to eat and drink and could identify the risks of not receiving adequate nutrition.
The registered provider carried out medication audits, although we found these were not always fully completed. Daily notes were also checked to ensure visits had taken place and times recorded match staff time sheets. Some of the policies we checked were not up-to-date.
Notifications were not submitted to the CQC as required under the terms of the registered provider’s registration. We dealt with this outside the inspection process.