2 March 2016
During a routine inspection
There was not a registered manager since 17 November 2015 the manager at the time of our inspection had just applied to become the registered manager. A registered manager is a person who has registered with the 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.
Accidents and incidents were recorded by staff but no follow up or risk assessments were completed to keep people safe. There were no systems in place to monitor risk to people’s health and well- being.
People told us that they felt safe, happy and well looked after in their homes. Staff had received training in how to safeguard people from abuse. Staff would report concerns to the manager and the family. However staff were not aware of the process for reporting to the local authorities. The recruitment processes were not safe and effective. There were not sufficient staff resources to always cover staff when required.
Medicines Administration Records (MAR) were not always completed properly and we saw no evidence that medicine audits had been completed or staff received competency checks in medicine administration.
There were no systems in place that enabled staff to identify trends and patterns emerging to prevent risks and improve the service. The provider did not have effective governance in place. There were no systems to audit, monitor and drive improvement.
People knew how to complain. However there were no effective and accessible systems for identifying, receiving, handling and responding to complaints from people who used the service.
Relatives and people were positive about the skills, experience and abilities of staff who worked in their homes. Staff received four days training in Poland, however the training did not cover all areas of people’s needs and we saw no evidence of additional training for staff to enable them to support people’s needs. Staff had not received regular supervision to discuss and review their development and performance.
Staff had developed positive and caring relationships with the people they cared for and clearly knew them very well. People had been involved in the initial assessments of their care but not everyone received regular reviews of their care and support.
Care was provided in a way that promoted people’s dignity and respected their privacy. However not all people received personalised care and support that met their changing needs and took account of their preferences.
People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.
Staff made considerable efforts to ascertain people’s wishes and obtain their consent before providing personal care and support, which they did in a kind and compassionate way.