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Archived: Sevacare - Leicester Requires improvement

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Reports


Inspection carried out on 5 January 2015

During a routine inspection

This inspection took place on 5 January 2015 and was unannounced.

Sevacare-Leicester provides personal to people in their own homes. At the time of this inspection there were 48 people using the service. The service provides personal care to older people, people living with dementia, people with learning disabilities, people with mental health needs, people with sensory needs and younger adults.

A registered manager was in post. 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.

At our last inspection on 6 August 2014 we identified some concerns with the care provided to people who used the service. People were not fully protected from unsafe care and support because plans of care had not always been reviewed to ensure they met people's changing care needs and risk assessments had not been undertaken for some people who had health conditions. People had been placed at risk because care and support was not always provided at the agreed times. Improvements were needed in relation to how the provider monitored the quality of the service provided. We asked the provider to send us an action plan outlining how they would make improvements.

At this inspection we found improvements had been made however further improvements were needed to ensure that people received care and support at the agreed times.

People who used the service told us that they felt safe with staff.

Staff had received training on how to protect people who used the service from abuse or harm. They demonstrated they were aware of their role and responsibilities in keeping people as safe as possible.

Recruitment checks had been carried out to keep people safe.

Medication records did not always show that people had received their medications.

Assessments of the risks associated with people’s care required improvement to ensure that staff knew how to provide safe care and support.

People who used the service and relatives told us they found staff to be caring, compassionate and respectful. They thought their rights to dignity, choice and independence were protected by staff. People told us that they were involved in decisions about their care. People told us that their consent was sought before care was provided to them. However, people’s capacity to make their own decisions was not always fully assessed.

Continuity of care was not promoted due to care not being provided to people by a consistent staff team. People told us that they were not always aware of which care workers would arrive to undertake their care calls.

Peoples complaints had been investigated but the outcome of the investigation had not always been communicated to them.

Some people were concerned about the poor communication and action from the office of the service.

The provider had internal quality and monitoring procedures in place though these were not always effective. Spot checks to assess the quality of care supplied to people required further development..

The registered manager gave staff the opportunity to share their views about the service provided.

The provider supported staff by an induction and ongoing support, training and development. However, training was not comprehensive to enable staff to be fully equipped to deal with all the needs that people had.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds to a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 . You can see what action we told the provider to take at the back of the full version of this report.

Inspection carried out on 6 August 2014

During an inspection in response to concerns

As part of this inspection we spoke with nine people who used the service and four family members, ten support workers and two members of the management team. We looked at a number of records including people's personal records and records kept in relation to the management of the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask. This is a summary of what we found:

Is the service safe?

People told us that they felt safe with the support workers who supported them and that they were treated well. One person explained: “I definitely feel safe; I wouldn’t let them in if I didn’t feel safe.” A family member told us: “I feel he is safe and any problems they [the office] get straight on to them.”

One family member explained that their relative required two support workers at each visit so that they could be supported safely. We were told that on a number of occasions the second support worker had arrived much later than the first support worker. This resulted in the support workers rushing to get the call completed on time. The family member told us that there had been occasions where the second support worker had not turned up at all. As a result of this, the one support worker carried out the call with the help of the family member. This meant that the person who used the service was at risk of not having their care and support needs met safely.

Support workers and members of the management team knew what to do if they suspected that someone had been abused. One support worker explained: “I would ring my line manager straight the way and write up a report.”

Not everyone had the necessary risk assessments in place. This meant that people were at risk of receiving unsafe care and support and their health and welfare needs were not properly protected.

Personal protective equipment was available for support workers to use including disposable aprons and gloves. This meant that care and support was provided in line with the services infection control policy.

Is the service effective?

We spoke with nine people who used the service and four family members and they told us that overall, they were satisfied with the care and support they received, but one or two things let the service down. One person explained: “The carers are lovely, they have been coming for quite a while now, I am quite satisfied.” A family member told us: “They should come between nine and half past, but they have been coming at a quarter to ten this week, it’s no good because the call is set around her medication, the time was agreed when we started, but they change it.” Another person who used the service told us: “I am quite happy with them”, whilst another family member explained: “We have had several issues about how they clean up after his care and the support workers telling us that they were unable to help him, but we contacted the office and action has been taken.”

Care plans provided support workers with information about people’s care and support needs. However, not everyone who used the service had a completed care plan in place. It was also evident that not all of them included all the tasks the support workers were required to carry out. This meant that there was a risk of their care and support needs not being met.

Is the service caring?

We spoke with nine people who used the service and four family members and they told us that, overall, they were happy with the support workers who provided their care and support. They told us that the support workers showed them respect at all times and they provided their care and support in a kind and friendly manner. One person told us: “Some of the carers are really nice; some need more training, the one who washed my hair last week was not so good.” A family member told us: “Xxxx [a support worker] is very good, she encourages her [their relative] to eat and take her medication and sits and holds her hand, she’s lovely.”

Is the service responsive?

The provider could not demonstrate that people who used the service had had their needs assessed before their care package commenced.

The provider had an effective complaints procedure that ensured complaints were taken seriously and appropriately investigated. People who used the service had been given a copy of the procedure. This ensured that they knew what to do if they were unhappy with the service they received. People told us that they knew what to do if they weren’t happy. One person told us: “I would ring the office; I have the number in the paperwork that I have.”

Is the service well-led?

We spoke with nine people who used the service and four family members. Of those people spoken with, four told us that they had experienced missed calls and five people were not happy about the times of their calls changing. This meant that they had not received the care and support that had been agreed and recorded in their care plan. One person told us: “The calls can be very hit and miss.” Another person explained: “They missed a visit last week because they got something wrong in the office.”

People who used the service were provided with a copy of its Service User Guide. This document explained to the reader the aims and objectives of the service and what they could expect from the service themselves. This ensured that they were fully informed of the service and what it offered. We noted that the service user guide did not include information regarding cancellation of calls, namely, being charged for a call if cancelled with less than 24 hours’ notice. The provider may find it useful to note that by adding this information, people who used the service would understand their obligations and responsibilities.

A quality monitoring system was in place, however shortfalls identified within the auditing processes raised the question as to whether these were effective or robust.