This was an announced inspection which took place on 6 and 7 January 2016. We gave the provider 48 hours’ notice to ensure that the registered manager was available for our inspection.
We previously carried out an inspection on 14 July 2014 in response to concerns about the service. On that inspection, we found the service had breached three regulations relating to the delivery of care: Care and welfare of people who use services, assessing and monitoring the quality of service provision, and requirements relating to workers. On this inspection we found that the provider had made some improvements in relation to these breaches.
C&S Homecare Limited is a domiciliary care service registered to provide personal care to people in their own homes. At the time of our inspection, C&S Homecare Limited was providing a service to 46 people, 34 of whom received personal care. C&S Homecare Limited provide personal care to people with a range of health conditions, including physical disabilities, dementia, Parkinson’s disease and diabetes.
The provider employed 27 staff and 26 staff were involved in providing personal care. There was a registered manager in post at the time of our 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 provider did not have a robust system in place to ensure that the quality of people’s care was audited, and steps taken to improve the service.
Risk assessments were not always in place to enable staff to identify risks associated with people’s care and take steps to minimise them.
There were enough staff available to meet people’s needs, but people did not always receive care at the times they expected. Staff were given an induction, but were not always given the training they needed to meet the needs of people they provided care for. Staff supervisions and appraisals did not always take place as planned.
People were protected from the risk of abuse. Staff understood how to recognise suspected abuse and felt confident to report concerns. The provider had policies and procedures in place to support staff to report abuse or allegations of abuse.
The manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005. However, not all staff had undertaken training in the principles of the MCA.
People were supported by staff to access healthcare professionals to maintain their health and wellbeing.
People felt supported by staff who cared for them, and who treated them with dignity and respect.
People knew how to make a complaint, and the provider demonstrated that they investigated, responded and took action to improve the service.
People who used the service, and their relatives, were given the opportunity to share their views on the quality of the service. The provider analysed this feedback to improve the quality of the service. However, the provider’s quality assurance systems did not always identify areas of poor care.
On this inspection we found a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
You can see what action we told the provider to take at the back of the full version of the report.