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Quality Homecare (Barnsley) Limited Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 30 January 2019

The inspection of Quality Home Care took place on 5 and 11 December 2018 with telephone calls being made to staff on 12 December 2018 and people who use the service on 17 and 18 December 2018. We previously inspected the service on 11, 18 and 19 September 2018. At that time the service was not meeting the regulations related to consent, good governance and fit and proper persons employed. The service was rated requires improvement.

Following the last inspection the registered provider told us the improvements they would make to comply with the regulations. On this inspection we checked and found some improvements had been made, however the registered provider was not meeting the regulations related to good governance.

Quality Homecare (Barnsley) Limited is a domiciliary care agency registered to provide personal care for people living in their own homes. Not everyone using Quality Home Care receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. At the time of the inspection the agency was supporting approximately 54 people.

There was a manager at the service who was registered with the Care Quality Commission (CQC.) A registered manager is a person who has registered with CQC 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 and associated Regulations about how the service is run.

Staff employed by the service had been vetted to work with people that might be vulnerable, although one gap in employment had not been explored.

We found improvements had been made to the system in place to ensure sufficient time was left between visits, so people received their medicines in accordance with the prescription, although some gaps in governance still remained.

A system was in place to monitor, record and reduce the risks of very late or missed visits. Evidence was not always recorded about how inconsistencies in the electronic logging in and out system were followed up.

Most people told us there had been no recent missed calls and their visits were completed at the scheduled time.

Risks were assessed and measures put in place to reduce the risks. Staff competency checks, in respect of medicines, had been carried out in line with National Institute for Clinical Excellence (NICE) guidelines.

Care staff had a good understanding of what to do if they saw or suspected abuse during their visits and we saw concerns had been acted on when they arose.

We saw evidence people had given their consent to the care and support they were receiving. However some consent records were inconsistent and evidence of representatives’ legal authority was not always recorded.

Staff told us they felt supported and received supervision and training and we saw regular observations of practice were completed.

People and the relatives we spoke with told us they were treated with consideration and respect by care staff during their visits.

Care plans usually contained sufficient up to date and relevant information to provide direction for staff, although there were some inconsistencies. Staff we spoke with told us they were familiar with people's individual needs.

People told us they knew how to complain and no complaints had been made to the service since our last inspection.

The registered provider had put some measures in place to monitor and improve the quality and safety of the service, however they were not always consistently applied. Some evidence was available that issues arising from audits had been followed up, however this was not always recorded.

We found a continuing breach of regulation 17 (1) and (2)(a)(b) (c) (f) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, good governance, because systems were not always operating effectively to assess, monitor

Inspection areas

Safe

Requires improvement

Updated 30 January 2019

The service was not always safe.

People told us they felt safe.

The registered provider had an overview of medicines safety and missed calls, however some issues had not been identified.

Recruitment procedures were in place to protect people from unsuitable staff, although one gap in employment had not been explored.

Safeguarding concerns where acted on when they arose and measures put in place to keep people safe.

Effective

Requires improvement

Updated 30 January 2019

The service was not always effective.

Consent was usually recorded, although there were some inconsistencies, and for two people, where records stated relatives had power of attorney to consent, this was not evidenced.

Staff had received supervision, observation and training to enable them to provide effective support to people who used the service.

People were supported to have sufficient to eat and drink and access healthcare professionals when necessary.

Caring

Good

Updated 30 January 2019

The service was caring.

People told us staff were caring and supported their privacy and dignity when delivering care.

Staff spoke in a professional and caring manner about their job and the people they supported.

The service took account of people’s preferences regarding the carers who supported them.

Responsive

Requires improvement

Updated 30 January 2019

The service was not always responsive.

New care plans were in place, however one contained conflicting information.

People told us they were involved in the development of their care plans.

People told us they knew how to complain and managers were approachable.

Well-led

Requires improvement

Updated 30 January 2019

The service was not always well-led.

Accurate records were not always kept, because some records contained conflicting information.

The provider’s systems and processes were not always operated effectively to assess, monitor and improve the quality and safety of the service.

Feedback had been sought from people and analysed by the registered manager in order to improve the quality of the service.

The registered manager and registered provider had taken some action to improve the quality and safety of the service.