Background to this inspection
Updated
20 October 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 15 and 18 September 2016 and was conducted by two inspectors and an expert by experience who assisted us by conducting telephone interviews with people who used the service after our inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The inspection was announced. We gave the provider 48 hours’ notice of our inspection as we wanted to be sure that someone would be available.
Prior to the inspection we reviewed the information we held about the service and we contacted a representative from the local authority safeguarding team.
We spoke with seven care workers after our visit over the telephone. We spoke with 20 people using the service, six relatives of people using the service and senior staff at the service. We also looked at a sample of 25 people’s care records, 12 staff records and records related to the management of the service.
Updated
20 October 2016
We conducted an inspection of Sagecare (Fulham) on 15 and 18 August 2016. At our last inspection on 29 January 2014 the service was meeting the regulations looked at. The service provides care and support to people living in their own homes. There were 430 people using the service when we visited.
There was a registered manager at the service. 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 2008 and associated Regulations about how the service is run.
Risk assessments and support plans contained some information for staff, but we saw many examples of incomplete or inconsistent record keeping.
Medicines were not accurately recorded when care workers prompted people to take their medicines, so it was not possible to determine what medicine people had taken and when.
Safeguarding adults from abuse procedures were robust and staff understood how to safeguard people they supported. Staff had received safeguarding adults training and were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.
Staff demonstrated knowledge of their responsibilities under the Mental Capacity Act 2005. However, records did not always contain details of people’s capacity and senior staff did not ascertain whether signatories to documentation had the legal authority to make decisions on people’s behalf.
Staff demonstrated an understanding of people’s life histories and current circumstances and supported people to meet their individual needs in a caring way. However, care records contained very limited details about people’s individual needs or preferences.
People using the service and their relatives were involved in decisions about their care and how their needs were met.
Recruitment procedures ensured that only staff who were suitable, worked within the service. There was an induction programme for new staff, which prepared them for their role.
Care workers were provided with appropriate training to help them carry out their duties. Care workers received regular supervision and appraisals of their performance. There were enough staff employed to meet people’s needs.
People were supported to maintain a balanced, nutritious diet where this formed part of their package of care.
People using the service and staff felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was a complaints policy and procedure in place.
The provider’s systems for monitoring the quality of the service were not always effective. Lessons learned was not always explored following accidents and incidents. Information was not reported to the Care Quality Commission (CQC) as required. We found evidence of two safeguarding incidents that were not reported in line with requirements. We saw evidence that feedback was obtained by people using the service and the results of this was positive.
During this inspection we found breaches of regulations in relation to safe care and treatment, consent, good governance and submitting notifications to the CQC. You can see what action we told the provider to take at the back of the full version of the report.