Archived: Sagecare (Fulham)

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.

The service had systems in place to ensure that people received safe care. Relevant training and supervision were provided for staff.

Sagecare had systems for monitoring of the quality of service provision and seeking the views of all users across a year. People's concerns were dealt with in face to face meetings so few reached the stage of formal complaints. Staff said they knew how to respond to people's concerns.

The registered manager had recently left the service and we were told that the provider would soon appoint a new manager.

The majority of people were complimentary about the staff and confirmed that they saw the same carer. Staff rotas were planned to prioritise those that needed care at specific times and to ensure continuity of care by providing the same carer for people. All staff had the appropriate recruitment checks prior to starting work. All staff received basic life support and infection control training. People we spoke with had no concerns about the skills of the care staff. One person described their carer as "fabulous".

Overall, we saw that there were effective systems in place to obtain consent, manage risks, complaints and to ensure people were protected from the risk of infection.