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Figtree Care Services Ltd Requires improvement

We are carrying out checks at Figtree Care Services Ltd. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 28 October 2017

We inspected Figtree Care Services on the 24 and 25 August 2017. The inspection was announced. Figtree Care Services provides support for older people living in their own homes. There were 35 people using the service at the time of our inspection.

There was not a registered manager in post who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 registered manager had left the service since our last inspection and a new manager had been appointed. The acting manager was going through the processes to become registered with the CQC.

We previously inspected this service on 7 and 8 July 2016 when we found breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. The breaches of the regulations related to safe recruitments practices, assessing risk, care plans did not set out the needs of people, records were poorly written and no effective auditing systems were in place. We found on this inspection that improvements had been made but there were still areas where the service was in breach of regulations.

The provider had systems in place to identify individual risks to people. However, formal environmental risk assessments had not been completed. We have made a recommendation about this in our report.

People were protected from abuse by trained staff who understood how to recognise the signs of abuse and how they should report it. Staff received training that gave them the confidence and knowledge to provide effective care.

The provider had safe recruitment practices in place. All staff had a safety check to ensure they were safe to work with vulnerable adults. All staff received regular supervisions and yearly appraisals. The acting manager was carrying out spot checks of staff performance to ensure they were working in line with the provider's policy and procedures. There were enough staff to provide care and support for the people. However, we found that there were some occasions when staff were late to calls and people had not been informed. We have made a recommendation about this in our report.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Mental capacity assessments were being carried out and these were decision specific. Staff and the manager demonstrated good knowledge of the Mental Capacity Act 2005.

People were supported to have a healthy and nutritious diet. Staff would support people when needed. People and relatives told us they were given choice over what meals they would have.

People and relatives we spoke to spoke positively about the staff and the care they received. Staff were seen to be communicating to people in a kind and caring way. Staff protected people’s dignity and encouraged independence. Staff demonstrated good knowledge of people and the care they required.

Care plans were detailed and identified each person’s needs. However, reviews were inconsistent and were not being reviewed in a timely manner following changes of people’s needs. Care plans identified people’s preferred likes and dislikes when receiving personal care and staff were aware of these. Staff ensured that people were given choice over their care.

People, relatives and staff told us that the acting manager was having a positive impact on the service. The acting manager had identified that the current auditing systems required improvements but new methods had not been embedded within the service. People’s records were not being consistently updated when required.

We found breaches in the regulations and you can see what action we took at the end of this report.

Inspection areas

Safe

Requires improvement

Updated 28 October 2017

The service was not always safe.

Risk assessments had been completed for people. However, risk assessments were not being completed for environmental risk.

The provider had ensured safe recruitment practices.

People were protected against abuse by trained, knowledgeable staff.

Effective

Good

Updated 28 October 2017

The service was effective.

Staff received suitable training that gave them confidence to provide effective care.

The principles of the Mental Capacity Act were understood and applied in practice by staff.

People were supported to have food which met their dietary requirements. People were given choice on what they wanted to eat.

Caring

Good

Updated 28 October 2017

The service was caring.

People and relatives told us they were happy with the staff at the service. Staff had good knowledge of the people they supported.

People privacy and dignity was maintained by staff. Staff encouraged people to be as independent as possible.

People private information was stored securely.

Responsive

Requires improvement

Updated 28 October 2017

The service was not always responsive.

People were not receiving reviews of their care in a timely manner.

People were encouraged to make their own choices in regard to the care they received.

The manager investigated complaints and the provider had ensured that people were aware of the complaints procedure.

Well-led

Requires improvement

Updated 28 October 2017

The service was not always well-led.

People, relatives and staff spoke positively about the new acting manager. The acting manager was seen to be open, transparent and approachable. People, relatives and staff could approach the acting manager at any time with a concern.

The acting manager had identified that auditing systems required improvements but the new systems had not been embedded within the service.

The provider had systems in place to ensure that all required notifications were made to the Care Quality Commission