17 May 2016
During a routine inspection
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.
The service provided people with personal care and support in their own homes. There was one person using the service at the time of this 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 registered manager is also the registered provider and will be referred to as the ‘provider’ throughout this report.
The provider did not have robust recruitment procedures in place, to ensure staff were suitable or eligible to work and to provide safe support to people. Staff did not receive the training or supervision they needed to be able to support people in a safe or effective way. There were sufficient staff to provide care and support however some staff were recruited that did not have the necessary values and behaviours to work with people.
People's medicines were not managed safely, guidance for the safe administration of some medicines was not available for staff and sometimes people’s prescribed medicines were missed.
Effective systems were not in place to assess, monitor and improve quality and manage risks to ensure people's safety, health and wellbeing.
The provider did not notify us of events that affected the service provision.
People were not consulted on a regular basis to ensure the support being delivered continued to meet their needs. The care and support package was not regularly reviewed to ensure it met people's needs. Risk assessments were completed; however the person they related to was not included in the assessment.
Staff did not always express a caring attitude when working and referring to people who use social care services.
The provider did not have a complaints procedure; people would not know how to make a complaint if they wished to do so.