6 January 2016
During a routine inspection
The service had a Registered Manager. 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 service was last inspected in March 2014 when it was found to be compliant with the outcomes inspected.
People gave us mixed feedback about the service. People told us their regular carers were good and caring, but found that the service was not good when their regular carers were not available.
Care files were of a poor quality, they were task focussed and contained limited personalised information.
Risk assessments were insufficient. They were not robust and did not provide staff with the information they needed to reduce the risk of harm to people.
Where the service supported people with their medicines this was done by trained staff. However, associated medicines plans and records were poorly completed and people were at risk of not having their medicines administered as prescribed.
Where the service supported people with eating and drinking the information contained in their plans was insufficient and did not include information on specialist diets or how people liked to be supported.
Staff recruitment procedures were not robust and people were at risk of being supported by staff who were not suitable to work in a care environment. The service had not taken appropriate steps to ensure that staff were suitable to work with people in their homes.
Systems to monitor the quality of the service were not effective. The service did not consistently learn from complaints or incidents or use these to drive improvements to the service. The management and leadership of the service were not effective. We have made a recommendation about learning from incidents, accidents and complaints.
People felt safe and the service had safeguarding policies and procedures which were understood by staff. People had given their consent to their care and were involved in reviewing their care packages regularly.
People felt they were treated with dignity and respect. The service attempted to provide care workers who spoke the same language as people who used the service.
Staff received sufficient training and support to ensure they were suitably qualified to carry out their roles.
We found four breaches of regulations. You can see what action we have taken at the end of the report.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be
inspected again within six months.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.
This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements
when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.