Archived: OAA Care Limited Also known as Out & About & Away

The provider was served a notice under section 28 of the Health and Social Care Act 2008 on 6 May 2014 informing them of our decision to place this condition upon their registration.

The purpose of this inspection was to see if the provider had achieved and sustained compliance with the essential standards in which they were non-compliant. We found that although some improvements had been made to the service, sufficient improvements to ensure the care and welfare of people who used the service had not been made. As a result of this, the condition imposed on the provider on 6 May 2014 will remain in place.

At the time of our visit, eight people received a service providing personal care.

An adult social care inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

Some aspects of the service were not safe and these had not been identified or addressed by the provider.

People who used the service and their relatives told us the staff that supported them or their relatives provided a good standard of care. They told us that the staff were competent at their role.

The planning and delivery of care was not always safe. People and their relatives told us that on occasions, care appointments at their home had been cancelled at very short notice. In addition to this, care staff were sometimes late for appointments and people or their relatives were unable to contact the service.

Where people had identified risks, for example with behaviour that may be challenging, we saw that an assessment had been completed and a plan to guide staff on how to support the person safely was in place.

People were not always protected from the risks of unsafe or inappropriate care as their records did not contain accurate and appropriate information.

We have asked the provider to tell us what they are going to do to meet the requirements of the law and the improvements they intend to make in relation to the planning and delivery of care and record keeping.

Is the service effective?

People and their relatives told us they were involved in care planning and reviews. People and their relatives told us the care they received met their needs. We saw the home had implemented a system to review people's care needs on a six monthly basis to ensure changes in people's needs were identified.

Is the service caring?

Some aspects of the service did not demonstrate the provider had ensured the highest level of care possible had been delivered to people.

People gave positive feedback about the staff employed at the service and the level of care and support they received. One person we spoke with told us that their care worker was currently supporting them through a significant change in their life. They told us this had made a positive impact through what is a very challenging period to them.

People and their relatives told us they received the support they needed, however we did receive negative comments about the service. For example, a person's relative made reference to a small number of occasions when support appointments had been cancelled at the very last minute. Additionally, we were told of occasions when a support worker had attended to support people who had little or no knowledge of the complex needs of the person who required the support.

We have asked the provider to tell us what they are going to do to meet the requirements of the law and the improvements they intend to make in relation to improving the continuity of care provided.

Is the service responsive?

Some aspects of the service did not demonstrate the provider had been responsive to people or their relatives.

The provider told us they had received complaints and this was confirmed by people and their relatives. There was no evidence the provider had responded appropriately as there were no systems in place to record the provider's response.

We saw that the service had involved other healthcare professionals when required. For example, community nurses and community mental health teams were involved in people's care and support. We saw from people's records that the provider or a support worker had attended multi agency meetings about people at times.

We have asked the provider to tell us what they are going to do to meet the requirements of the law and the improvements they intend to make in relation to ensuring people and their relatives complaints are listened to, assessed and acted upon

Is the service well led?

Some aspects of the service were not well led as action had not been taken to rectify shortfalls.

There were no systems to seek the views of staff. This meant that the administrative failings identified to us by staff and people's relatives had not been identified by the provider.

The provider did not have a system to assess, evaluate and respond to complaints to ensure a high quality of service was delivered to people.

The provider did not have a system to monitor records made by staff or some records that related to the management of the service.

We saw that there were now systems in place to monitor the quality of the service provided. This included surveys to gather the views of the people who used the service and their relatives.

We have asked the provider to tell us what they are going to do to meet the requirements of the law and the improvements they intend to make in relation to seeking the views of staff, monitoring record keeping and complaints.

We served the warning notices requiring the provider to make the necessary improvements by 30 January 2014. The provider had taken action to address some areas. However, there were still areas where the provider needed to take action to ensure the standards of safety and quality for people were met.

Since the inspection the provider has written to us confirming they will not take on any new care packages until necessary improvements have been made. In addition the provider has sent us a more detailed action plan on how they will ensure on going compliance with clear timescales.

We met with the registered manager/provider and a member of staff. To enable us to seek the views of people who use the service and staff we completed telephone interviews. We spoke with three people who used the service and two members of staff.

People we spoke with told us they were happy with the care staff that supported them. Comments included 'the staff are kind and reliable', and 'the staff always ask me how I would like to be supported'.

We sought the views of three people who used the service, two people on the telephone and one through email on what they thought about the service provided by the agency. Generally people were satisfied with the care and support their received. Comments included 'the staff are lovely, kind and cannot fault them. The provider is very caring and promotes the rights of people with a physical disability'.

However, some people raised concerns about the administration of the business including dissatisfaction with the way they were invoiced for payment for the care they had received.

Care plans clearly described the care needs. Although these were not always available in the home of the people, which meant staff might not have current information in relation to the person's care.

Systems were not in place to review the quality of the service. This included seeking the views of people who used the service.

There was a lack of records that must be place to ensure compliance with the law. This included maintaining records in relation to recruitment and training of staff, complaints and records of care delivery. Records were not readily accessible.