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Archived: Choice Healthcare - Barnsley

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Inspection report

Date of Inspection: 5, 11 February 2014
Date of Publication: 15 March 2014
Inspection Report published 15 March 2014 PDF | 91.6 KB

The service should have quality checking systems to manage risks and assure the health, welfare and safety of people who receive care (outcome 16)

Not met this standard

We checked that people who use this service

  • Benefit from safe quality care, treatment and support, due to effective decision making and the management of risks to their health, welfare and safety.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 5 February 2014 and 11 February 2014, talked with people who use the service and talked with staff. We talked with other authorities.

Our judgement

The provider did not have effective systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

Reasons for our judgement

The care co-ordinator told us that people who used the service would be visited periodically to check that they were satisfied with the service and to provide any feedback. People we spoke with confirmed that someone had been to see them to discuss how they felt about their support and to see if they wanted to change anything. One person said, “We used to have more visits but I’ve cut them down as we don’t need the night carers anymore.” We saw the ‘quality questionnaire results’ that had been compiled from responses to questionnaires sent out in November 2013 to each person who used the service. Actions had been identified for implementation to address the issues identified, for example ensuring that people received rotas. This showed that people had opportunities to influence their care needs and feedback had been acted upon.

There was no evidence of formal quality monitoring systems in place. The manager and care co-ordinator told us that each month staff should bring completed documentation from people’s care plans into the office. This included medication records, daily journals and financial transaction records. The care co-ordinator told us that senior staff looked over these records however there was no process in place to evidence that these were checked nor were records brought in consistently. In one instance there were no financial records for one person who received assistance with shopping and purchases. This meant there was no process in place to monitor the care and support provided to people to ensure it was appropriate and to identify any areas that required improvement.

We saw that the service had a process in place for reporting incidents however these were not being followed up adequately. In one person’s care file we saw three separate incidents dating from July 2013. Two of these incidents consisted of safeguarding issues but had not been referred to the local authority as required. The service had also failed to notify us of the matters as is a requirement under the Health and Social Care Act 2008. The ‘actions to be taken’ completed for each of the three incidents was inappropriate and no feedback had been recorded to show whether the incidents had been resolved. The care co-ordinator told us they recalled some aspects of the incidents but was unable to say how they had been dealt with. The manager told us she had been unaware of the incidents at all.

Due to the nature of these incidents we spoke with the regional manager and asked them to refer these incidents to the local authority as required. We saw information to evidence that this action was undertaken. The initial failure to report these incidents to the relevant organisations meant there was a risk to people’s care and welfare due to inadequate processing and monitoring of incidents.

We saw details of a situation where allegations had been received that some service users were potentially at risk of unsafe care. The care co-ordinator told us this matter was being dealt with by senior management. We were aware that at the time of our inspection no measures had been put in place at to mitigate the risks to people. Therefore, people were still potentially being put at risk by lack of any discernible actions into these allegations. We asked the regional manager to ensure that this matter was also referred to the local authority as required, and again we saw evidence to confirm that this was done.

We viewed nine staff files and saw that only four of these contained evidence of spot checks and/or monitoring visits to observe staff competency. This showed that measures in place for monitoring staff efficiency were not routine.

No one we spoke with who used the service had any complaints. One person told us that they had made some ‘minor’ complaints previously and that these had been dealt with satisfactorily. As the service was unable to locate its complaints file we were unable to assess whether complaints were dealt with effectively and i