About the service Silverjen is a domiciliary care agency providing the regulated activity of personal care which is help with tasks related to personal hygiene and eating to people in their own homes. Where people received the regulated activity we also considered any wider social care provided. The service provides support to people with health conditions or those living with dementia. At the time of our inspection there were 58 people using the service.
People’s experience of using this service and what we found
Systems and processes within the agency were not sufficiently robust to identify shortfalls within the service. Administratively, there was a lack of organisation or delegation to enable records to be accessed by everyone in the office. Although staff loved their job, then felt demoralised by the actions of the registered manager. They told us they only heard the day before which care calls they would be going to the following day which left them feeling worried.
Where people lacked the capacity to make decisions for themselves, the registered manager had not always ensured they had followed the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the persons best interests.
Recruitment of staff covered a range of aspects to help ensure prospective staff were suitable for the role. However, we found that the registered manager was not always following guidance in relation to what checks should be undertaken.
People were happy with the care they received from the service. They told us staff stayed the full time expected and they had not experienced a missed call.
People received the medicines they required and they told us staff were good at prompting them to take their medicines. Although, this was the case, office staff had not robustly audited the medicines records for their accuracy and they had not picked up the shortfalls in the record keeping.
People felt safe in the hands of care staff and risks to people had been identified. and Guidance was in place for staff to help reduce any risk to the person. Where concerns had been raised of possible abuse, these had been reported to the appropriate authorities and investigated by the. Accidents and incidents were recorded and external support was sought where incidents were having an impact on people.
People told us staff treated them with respect and encouraged them in their independence. People told us staff wore appropriate personal protective equipment when providing personal care and they considered people’s individual wishes in relation to their care.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. People were encouraged to be independent and make choices around their care. People were treated as an individual by staff and were provided with respect. Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives;
Carers demonstrated a good ethos, one that was centred on the people they provided care to. Carers had received relevant training in caring for someone who had a learning disability.
Staff received appropriate training to enable them to carry out their role and care for people in a relevant and safe way. Staff supported people to access external agencies when they were unwell or required additional support. Such as the GP or to obtain equipment for them.
People’s needs and preferences in relation to their food and drink were recorded and people were happy with this aspect of their care. Where people were able to, they could make their own decision on how they wished to be cared for. People knew how to make a complaint and individual communication difficulties were recognised by staff.
People were invited to give their feedback on the service they received. Comments were addressed and changes made to accommodate people’s wishes. The registered manager worked with external agencies to compliment the service they provided and they had a vision for the future expansion of Silverjen.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for the service at the previous premises was Good, published 11 February 2020.
Why we inspected
This inspection was prompted as the service had not been rated since it had moved premises.
Enforcement and Recommendations
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 and will take further action if needed.
We have found breaches of regulation in relation to adherence to recruitment checks, the principles of the Mental Capacity Act 2005 and good governance arrangements during this inspection. We have also made recommendations in relation to medicines administration practices.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will ask the registered provider to provide us with an action plan explaining how they plan to address the shortfalls we have identified on our visit. We will continue to monitor information we receive about the service, which will help inform when we next inspect.