Archived: De Vere Care - Milton Keynes

There was not a registered manager in post. 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 provider had failed to deploy sufficient numbers of staff in order to meet the needs of people who used the service and failed to demonstrate a systematic approach in determining the number of staff required. People were not always cared for by staff that had the knowledge, skills, experience and support they needed to carry out their roles. Staff did not receive appropriate supervision or training to enable them to fulfil their responsibilities.

The service had been without a registered manager in post for four months and this lack of leadership had significantly impacted on the quality of care that people had received. The provider did not appear to be aware of the seriousness of their lack of oversight of people’s care and the significant risks this posed to the people relying upon the service for their care.

The systems in place monitoring planned care visits to people was inadequate. The service had a call monitoring system in place which could not be relied upon as an accurate reflection that people had received their planned care.

The provider did not have sufficient guidance for staff to follow to show how risks to people were mitigated and not all potential risks had been assessed.

There were not always appropriate arrangements in place for the management of medicines. There were occasions when people did not receive their prescribed medicines because the provider did not ensure there was enough adequately deployed staff to meet their needs.

There was poor monitoring of people’s nutritional and hydration needs which put people at risk. Records could not be relied upon as an accurate account of people’s food and fluid intake. There was lack of monitoring and oversight of people who were at risk of not eating or drinking enough.

The provider had not changed their practice in relation to issues raised in verbal complaints and actions had not been identified to prevent similar concerns being raised.

Providers are required by law to notify Care Quality Commission (CQC) of certain events in the service such as serious injuries and safeguarding concerns. Notifications had not been reported to the CQC.

People were supported by staff who were aware of the requirements of the Mental Capacity Act 2005. People and relatives told us staff gave them choices.

Staff understood people's needs. However care plans were not up to date to support staff in delivering safe care and support in accordance with people's individual needs.

We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At the end of the inspection the provider informed us that they intended to close the service De Vere Care – Milton Keynes. They told us that they would work closely with the local authority to ensure that packages of care and support were provided by alternative agencies. The Care Quality Commission have received a notification from the provider to cancel their registration for this location.

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.

This inspection took place on 2 and 7 March 2016 and was announced.

The inspection was carried out by one inspector.

De Vere Care Milton Keynes provides personal care to people who live in their own homes in order for them to maintain their independence. At the time of our inspection the provider confirmed they were providing personal care to 38 people.

There was a registered manager in post. 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.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse and people had risk assessments in place to enable them to be as independent as possible.

Effective recruitment processes were in place and followed by the service and there were sufficient numbers of staff available to meet people’s care and support needs

People told us that their medicines were administered safely and on time.

Staff members had induction training when joining the service, as well as regular on-going training. Staff members were regularly encouraged to improve their skills with training.

Staff were well supported by the registered manager and senior team, and had regular one to one supervisions.

People’s consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met.

People were able to choose the food and drink they wanted and staff supported people with this.

People were supported to access health appointments when necessary.

Staff supported people in a caring manner. They knew the people they were supporting well and understood their needs and preferences.

People were involved in their own care planning and were able to contribute to the way in which they were supported.

People’s privacy and dignity was maintained at all times.

The service had a complaints procedure in place and people knew how to use it.

Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed.