Archived: Short Break Care

The provider had put measures in place to ensure that users of the service were safeguarded against the risk of abuse by identifying and responding appropriately to incidents involving allegations of abuse. Relatives and advocates of people who use the service told us they felt people were safe and they trusted staff. One relative told us, 'They (staff) make X feel very safe.'

During our inspection we found the provider had put measures in place to strengthen the recruitment, interview and selection process. The provider's 'Recruitment policy and procedures' documentation was revised in July 2013. We noted that new applicants were required to provide a full employment history with a written explanation of any gaps in employment. Other measures included the completion of health checks prior to employment.

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Existing staff recruitment files were reviewed by the provider. We saw evidence of written explanations for gaps in employment histories and health checks had been completed. This was to ensure that people who use the service were not placed at risk of being cared for by staff who were not suitable to provide their care and treatment.

There were systems for monitoring the quality and safety of services provided to people. These included recording and investigating complaints, and collecting feedback from relatives and representatives of people who use the service and staff. People were asked for their opinions about the quality of care provided. The service conducted a survey in June 2013 to ensure care provision met people's expectations. Responses were highly favourable. The provider had completed management spot checks to monitor the quality and safety of services provided to people in their own homes. Where improvements to services were required, these were made.

However, although some of the concerns from our last inspection had been addressed not all of the required information checks were in place prior to the employment of staff. Examples included; full employment histories and health checks.

We found staff records and other records relevant to the management of the service were accurate and fit for purpose. People's care documentation was stored securely and accessible only by care workers and management.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. One relative told us 'If they want X to do something they take time to give X space to come to the decision.'

People who use the service told us they felt safe and trusted staff. However the provider had not ensured that users of the service were safeguarded against the risk of abuse by responding appropriately to incidents involving allegations of abuse.

All the required information checks were not in place prior to the employment of staff. This meant the provider did not have an effective recruitment process to ensure that people who use the service were not placed at risk of being cared for by staff who were not suitable.

A system of staff supervision and appraisal was in place to support workers. However, staff did not receive appropriate training and professional development to enable them to deliver care and treatment to service users safely and to an appropriate standard, especially during their induction.

There were systems for monitoring the quality and safety of services provided to people. These included recording and investigating complaints, and collecting feedback from relatives and representatives of people who use the service and staff. However, there were no spot checks by management in place to monitor the quality and safety of services provided to people in their own homes. Where improvements to services were required, these were made.

Staff records and other records relevant to the management of the service were not accurate or fit for purpose. We found that records were not kept securely or for the appropriate length of time.

We spoke with staff and looked at people's care plans and found their needs were assessed, and care and support was planned and delivered in line with their individual needs.

People using the service were not protected from the risk of abuse, because the provider had not taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. However people who used the service told us they trusted staff and felt safe in their care.

The provider had not ensured staff received appropriate professional development or consistent support to deliver care and support to the people who use the service.

The provider did not have a system for monitoring the quality of service provided and could not evidence that feedback to improve the service was acted upon. Processes were in place to identify, assess and manage risks to the health, safety and welfare of people using the service however these were not always followed.