14 November 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. At the time of our inspection the registered manager was no longer actively fulfilling this role. The management of the service was carried out by the provider’s senior management team whilst they recruited for a new registered manager.
People told us they felt safe from abuse or harm from their care workers and they were supported safely by care staff. Staff had completed training in safeguarding children and adults from abuse and appropriate actions had been taken when concerns about people’s safety had been raised.
Staff we spoke with understood the risks that people experienced and took the appropriate actions to ensure people received safe and appropriate care. The provider had introduced an electronic care planning system PASS which enabled them to monitor risks to people when care was not delivered as planned. People were supported safely.
The provider had experienced some key office administration and management staff changes which had resulted in the day to day management of the service being overseen by the provider’s senior management team. This was to support the new office team through an induction into their roles. At the time of our inspection care supervisors and care coordinators were also providing personal care to people to ensure people’s care needs were met. There had been some disruption to the service people received however, this was improving as new care staff were recruited and office staff completed their induction. People told us that care staff were usually on time and stayed for the time agreed. Although people did not always experience the consistency of staff they would prefer; people did not report any harm as a result of these changes and had not reported any missed calls. Overall there were sufficient suitably qualified staff available to meet people’s needs.
People’s medicines were managed safely by appropriately trained staff and the provider monitored the administration of people’s medicines through their PASS system. This enabled them to check people had received their prescribed medicines at the time they required them.
People were protected from the employment of unsuitable staff because the provider carried out the relevant checks to ensure staff were recruited safely.
Staff completed an induction and on-going training in their role to enable them to care for people safely and effectively. Regular supervision was provided to staff so they were supported in their role.
People told us staff supported them to be as independent as they were able to be. People’s legal rights were upheld because the provider’s staff understood the principles of the Mental Capacity Act 2005 (MCA). People were asked for their consent to their care plan and where appropriate the provider sought confirmation of the legal authority other people held to make decisions on behalf of a person. This is important to ensure people were protected from inappropriate and unlawful decision making.
People we spoke with who were supported with their meals told us they were satisfied with the support they received. Risks to people from poor hydration and nutrition were assessed and guidance provided to staff to ensure people’s nutrition needs were met in line with their preferences.
People told us they received care from healthcare professionals as required. The provider’s staff supported people with their healthcare needs by providing care to manage risks to their health, such as the prevention of pressure sores.
People told us they received care from kind and compassionate staff who treated them with dignity and respect. Although people did not always receive care from the same staff due to staffing changes, existing staff worked hard to ensure people had as much consistency of staff as possible
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Peoples’ care plans included information about their lifestyle choices, interests and personal histories. This supported staff to build positive relationships with people based on their preferences and interests. People spoke highly of the provider’s staff and valued their relationships with them.
Records showed that people’s care, and support needs were set out in a care plan that described what staff needed to do to make sure personalised care was provided. Care plans were based on an assessment of people’s needs and the outcomes people wished to experience as a result of the care they received. At the time of our inspection people’s care plans were being transferred to PASS which enabled the provider to ensure tasks were completed as planned.
People and their relatives knew how to make a complaint. The provider had a process in place to investigate and respond to complaints and concerns and we saw complaints made had been managed in line with these procedures.
People’s feedback about their contact and communication with the provider was consistently good. Although people acknowledged staffing changes had caused some disruption to the service, people also expressed trust and confidence in the provider to address the situation.
The provider had a quality improvement plan in place and action was being taken to drive improvements to the service. This included the recruitment, retention and continuity of staff. The provider sought feedback from people and staff and used this to inform and make improvements to the service.
Staff spoke positively about working for the provider and were confident about reporting concerns and felt their views were taken into account.
The provider worked with other organisations to ensure current practice was being followed and to promote an awareness of the needs of the people they supported. This included a campaign to highlight the issue of loneliness in old age as well as community engagement events.