Archived: CASA Leeds

People’s experience of using this service:

People told us that although they did not experience missed visits, continuity of staff was poor and staff were not always on time which meant that continuity of care for people using the service was not optimal. Staff were recruited safely, and the registered manager was monitoring staff continuity and timekeeping.

People’s care needs were assessed, and care plans were created which took into account people’s personal history and preferences as well as assessments of risk and what help people needed.

People told us staff were kind and caring, and that staff helped them to live independently. Staff were able to describe how they would protect vulnerable adults from harm and maintain their independence and dignity.

People said staff were well trained to meet their needs. Staff said they received good levels of support through supervisions and appraisals.

People said management of the service had improved, that their complaints were listened to, and that they were asked their opinion of how the service could improve. The provider was developing a new set of values as part of its vision to improve the service, and staff said they felt involved in the development of this new identity. Staff said they were confident in the leadership of the service.

Rating at last inspection:

At the last inspection in November 2017 the service was rated requires improvement with two breaches of the Health and Social Care Act 2008 (Regulations 2014) Regulated Activities. They were breaches of Regulation 17 (Good Governance) and Regulation 18 (Safe Staffing).

Why we inspected:

This was a scheduled/planned inspection based on the previous rating.

Follow up:

We will continue to monitor the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Not everyone using CASA Leeds receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

We inspected CASA Leeds on 29 November and 7 December. We gave the service 48 hours’ notice of our inspection because the service provides care in people’s own homes and we wanted to make sure staff would be in the office and that the manager was available.

At the last inspection in November 2015 the service was rated overall as ‘Good’.

There was no registered manager in place for the service. The service had a manager who was in the process of registering with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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.

There were not enough staff to meet people’s needs, and people told us that staff were frequently late or missed their visits. We received mixed feedback from people on the competency and suitability of staff who cared for them

Records relating to the safe management of medicines were not completed well, however we did not see any evidence that the management of medicines in other areas was unsafe.

We found two breaches of regulations in relation to staffing and good governance. This was because there were not enough suitably qualified and competent staff deployed to meet people’s needs, and because the systems and processes in place did not effectively monitor and improve the quality and safety of the service.

You can see the action we have asked the provider to take at the back of the full version of this report.

People we spoke with told us their complaints were not always responded to appropriately and they felt they were not listened to. We have made a recommendation about the management of complaints made about the service because people told us they felt they weren’t listened to when they rang the office with concerns.

Staff were recruited safely, with appropriate background checks carried out.

Risks to people were assessed appropriately, and staff knew how to spot signs of abuse and act appropriately in line with the provider’s safeguarding procedures.

Staff were provided with an induction and training programme that they felt met their needs. Staff felt well supported through supervisions, appraisals and spot checks.

People were supported to eat and drink enough, and people told us they were well supported with their health needs.

People told us care workers were kind and compassionate and that their dignity and privacy was protected. Staff were able to describe how they maintained people’s dignity and privacy when carrying out personal care. Staff described how they supported people to maintain their independence.

Care plans were written in a person-centred way with good detailed guidelines for staff on caring for people the way they wanted to be cared for.

There was a new leadership team in place. Staff told us this had improved morale.

The provider had for a long time been unable to monitor the quality of the service due to a failure of their computer systems and efforts to rectify this had been unsuccessful and resulted in missed visits.

The provider sought people’s feedback on the quality of the care it provided through surveys and quality monitoring calls.

There were enough qualified, skilled and experienced staff to meet people's needs, and people received consistent care and support that met their needs. Staff said they nearly always supported the same people so knew the people they were supporting well.

People's rights were respected, and care and support was person centred. Systems were in place to make sure people's privacy, dignity, and independence were promoted. Staff had received training and support that helped them understand how to provide good care.

The provider had effective systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service. Quality assurance records showed overall people were happy with the care they received.