Archived: Local Care Services Limited

A longstanding and experienced registered manager was in place. 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 inspection took place between the 19 and 23 September 2016 and was announced. At the last inspection in February 2014 the provider was in breach of one regulation relating to the management of medicines. At this inspection, although some improvements had been made to the way medicines were managed, the provider had not fully complied with legal requirements. A complete record of the medicine support provided to people was not being documented.

Overall, people told us they felt safe using the service. Safeguarding procedures were in place and we saw evidence they had been followed.

Risks to people’s health and safety were assessed and clear and up-to-date plans of care put in place for staff to follow. People we spoke with told us that risks such as those associated with moving and handling were well managed by staff. Arrangements were in place to ensure staff acted appropriately in emergency situations.

We concluded there were sufficient staff to ensure people received a safe service. Staff were subject to the required checks on their characters and backgrounds to help ensure they were suitable to work with vulnerable people.

People said staff adhered to infection control procedures and staff reported a plentiful supply of equipment.

Most people told us staff had the right skills and knowledge to care for them. Staff received extensive training on induction and at regular intervals. Staff had a good knowledge of the people and topics we asked them about. Staff told us they felt well supported by the registered manager.

The service was acting within the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).

People told us they were supported appropriately to eat and drink. Care records showed people’s nutritional needs had been assessed and plans of care put in place.

People’s healthcare needs were assessed and we saw the service had regular contact with health professionals to help maintain people’s health.

People and relatives all said staff were kind and caring and treated them with a high level of dignity and respect. Information had been sought on people’s likes, dislikes and life histories to help provide personalised care and support.

The registered manager and staff told us where possible they tried to ensure continuity of care staff. However some people told us that there was a lack of continuity of care workers and they would prefer a smaller team of care staff.

People and relatives told us care needs were met by the service. Care records showed people’s care needs were assessed in a range of areas and appropriate plans of care put in place for staff to follow.

Staff were updated on people’s changing needs through regular contact from the office and a weekly newsletter.

A range of audits and checks were undertaken on staff and care records to help maintain a high quality service. People’s feedback was regularly sought. We identified systems to analyse occurrences within the service such as verbal complaints and any incidents should have been more robust.

The service had not fully acted on the Commission’s feedback at the previous inspection or followed the action plan submitted to us, as a complete record of the medication support provided to people was not in place.

We identified one breach of the Health and Social Care Act (2008) Regulated Activities 2014 Regulations. You can see what action we asked the provider to take at the back of this report.

Appropriate checks were undertaken before staff began work. We spoke with ten people who used the service and/or their relatives and they told us the agency appeared to employ enough staff and calls were not missed and seldom late. One person said "I have no concerns they care for me very well'. Another said 'All the staff was kind and caring' and they are 'Wonderful'.

We found the provider had an effective system in place to regularly assess and monitor the quality of service that people received. However we found people were not fully protected against the risks associated with medicines because at the time of our inspection the provider did not have appropriate arrangements in place to record the administration of medications.

People who use the service told us they were happy and satisfied with the care and support being provided. They made comments like, "I would recommend this agency to anyone. They are faultless.' And 'They have never let me down. They are 'A' star.'

People also told us staff supported them as they wished to be supported and were always professional. They felt people respected their privacy and protected their dignity.

We looked at people's care records. We found that records were consistent, accurate and up to date. We also saw that the service delivered the care in a person centred way which meant that they included people in decision making throughout their care.

We spoke with staff who told us they were well trained and felt confident to do their work. They also said they were always well supported by the management team to do their job.

We saw that the service consitently reviewed the satisfaction of people using the service. They contacted people regularly to ask if they were happy with the care they received. We also saw they sent out customer satisfaction questionnaires each year. They took forward the comments made, to further review the service they provided.