Background to this inspection
Updated
27 July 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. This service is a domiciliary care agency. It provides personal care to people living in their own houses and
flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was not available at the time of the inspection. The care manager supported us with the inspection.
Notice of inspection
Our inspection was announced. We gave the provider 48 hours’ notice and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
Before the inspection, we reviewed relevant information that we had about the service including any notifications of safeguarding or incidents affecting the safety and wellbeing of people. A notification is information about important events, which the provider is required to tell us about by law. We also checked the last inspection report and requested feedback from social care professionals.
The service completed a Provider Information Return (PIR). A PIR is a form that asks the provider to give some key information about the service, what it does well and any improvements they plan to make.
During the inspection
We spoke with the care manager and four care staff. We reviewed documents and records that related to people’s care and the management of the service. We reviewed eight people’s care plans and five staff recruitment files. We also looked at staff training records, audits, complaint records and incident records.
After the inspection
We spoke with four people and four relatives by telephone. We continued to seek further evidence and clarification from the provider.
Updated
27 July 2019
About the service
The service provided personal care to adults living in their own homes. At the time of our inspection, the service provided personal care to 11 people. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided
People’s experience of using this service
Procedures to protect people from abuse were not up to date and staff had not received adequate safeguarding adults training. Staff were not always recruited safely and new staff had not received a full induction. They were not fully supported with essential training and development to ensure their skills and knowledge were up to date.
Not all staff felt supported by the management team. The registered manager was not available for our inspection and did not work full time at the service. The care manager was responsible for the day to day running of the service. They carried out checks to ensure staff were providing a good standard of care.
Quality assurance systems in the service had not been implemented to follow up on recommendations we made at our last inspection, which meant the service had not sufficiently developed and improved.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. However, staff were not confident in explaining the principles of the Mental Capacity Act (2005).
People told us they were safe and were familiar with staff who provided care to them. They were happy with the service they received. Risks associated with people’s needs were assessed and staff understood how to reduce these risks. Staff arrived at times that suited people.
People were supported with their medicines. They were supported with maintaining their health and had access to health care professionals, such as GPs, when required.
Staff treated people with dignity and respected their privacy. Staff were kind and compassionate towards people and maintained positive relationships with them. They understood people’s needs, preferences and what was important to them. People’s independence was promoted.
Care plans were person-centred and detailed people’s support needs. People and relatives knew how to make complaints and were able to provide their feedback about the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
At the last inspection on 25 October 2016, the service was rated ‘Good’ (report published 16 December 2016). At this inspection the rating has deteriorated to 'Requires Improvement'.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We identified two breaches of Regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will monitor the progress of the improvements working alongside the provider and local authority. We will return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.