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East Riding Quality Home Care Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 16 November 2018

This announced inspection visit activity started 24 September 2018 and ended 2 October 2018. We gave the provider four days’ notice of our visit. We did this as we wanted to make sure the provider was available on the day of the inspection, and visits to people in their own home could be arranged (with consent). The inspection was completed by two inspectors.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults.

Not everyone using East Riding Quality Home Care receives the regulated activity; the Care Quality Commission (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 consider any wider social care provided. There were 37 people using this service at the time of our inspection, 25 people were receiving a regulated activity.

There was a registered manager in post at the time of the inspection. 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. The registered manager, who had been the previous provider, was not present at the time of inspection. Since the last inspection they had sold the service to a new provider and the service was in a period of transition. The new provider was present at the inspection.

People told us they felt safe, however staff had limited knowledge on safeguarding procedures. Risk assessments had not always been carried out when people had an identified need.

People received their medication safely although there were some issues with recording and auditing medication records.

It was unclear from peoples care records if they had the capacity to consent to their care plans.

Staff received training although we identified gaps in subjects meaning we could not be assured staff had the knowledge to meet people’s needs. Some staff had not received training in first aid, infection control, mental capacity act 2005 and equality and diversity. We were unable to see evidence for some staff of induction records.

Staff were not receiving appraisals, or meeting with the provider regular as stated in their policies. The provider showed evidence they had systems in place where they were in regular contact with staff and staff could raise any concerns.

Person centred detail was not always included in people’s care records. People’s care records did not always say how they like to receive support. The new provider informed us they were updating all care plans across the service. However, this work had not been completed when we inspected the service. The provider carried out regular reviews with people.

People and relatives told us staff were caring. We saw that staff knew people well and had good relationships. People's privacy and dignity were respected, and they were encouraged to be independent.

The provider used technology to monitor people’s calls and ensure calls where not missed. The system in place alerted the provider if staff where fifteen minutes late. The system ensured no calls where missed.

The provider had not operated a robust quality assurance system. Audits carried out had not identified the shortfalls which we found during this inspection. Where audits had highlighted improvement areas action had not always been taken to address them.

People and staff spoke highly of the new provider who had recently taken over the service.

Records had not always been completed fully.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection. You can see what action we told the provider to take at the back of this report.

Inspection areas

Safe

Requires improvement

Updated 16 November 2018

The service was not always safe.

Risk assessments were not always carried out when a risk was identified, to ensure that potential risks to people were minimised.

Staff were not aware of their responsibilities regarding safeguarding people.

People were recruited safely.

Effective

Requires improvement

Updated 16 November 2018

The service was not always effective.

Staff had not received induction and essential training and support needed to carry out their role. Staff were not receiving regular supervision and appraisal.

Caring

Good

Updated 16 November 2018

The service was caring.

People we spoke with were consistently positive about the staff and how caring they were.

We observed positive interactions between staff and people who used the service.

Responsive

Requires improvement

Updated 16 November 2018

The service was not always responsive

People were happy with the care they received, but care plans did not always include person centred detail.

The accessible information standard was met.

Well-led

Requires improvement

Updated 16 November 2018

The service was not always well-led.

Quality assurance audits were ineffective and did not pick up the short falls we identified at inspection. Records were not always completed fully

People who used the service and staff told us the provider was approachable.