Archived: Farringford Care Limited

Updated 14 September 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 and 16 June 2015 and was unannounced. Two social care inspectors attended the service on the first day. On the second day one social care inspector attended with an expert by experience. An expert by experience is someone who has used this type of service or knows about this because their relatives have received this type of care and support.

We moved this inspection forward because we had concerns that the registered provider may not be supporting people who used the service effectively. Prior to our inspection we reviewed all the intelligence CQC had to help inform us about the risk level for this service. We found that we had received no notifications from the registered provider. We reviewed all of our information to help us to make a judgement. We attended a meeting with the Clinical Commissioning Group [CCG] and registered provider prior to our inspection where information of concern was shared with us that the registered provider had not been able to cover their contractual obligation to people over one weekend of 29 May 2015 and they had asked for help from the CCG and other providers of care.

During our inspection we visited the registered provider’s office. We visited one person receiving a service in their own home. We used observation of the support the person was receiving to help us understand their experience of the service. We spoke with ten people who received a service and with six relatives by phone.

We looked at seven care files which belonged to people who used the service. We also looked at other important documentation relating to people who used the service such as incident and accident records and medicine administration records [MAR’s]. We looked at a selection of documents relating to the management and running of the service. These included policies and procedures, quality assurance documentation and complaint information. We also looked at staff rotas and four staff files which included training records supervision and information about recruitment.

During our inspection we spoke with the project manager, Nominated Individual and with 13 staff to gain their views.

Updated 14 September 2015

We undertook this unannounced inspection on the 12 and 16 June 2015. The last inspected took place on 23 and 28 April 2014 and the registered provider was found to be compliant with the regulations that we assessed.

Farringford Care Limited is registered with the Care Quality Commission [CQC] to provide personal care to people in their own homes. The service offers support to people living with dementia, learning disabilities, mental health conditions and physical disabilities. The service is available to people in the Grimsby and Cleethorpes area. If people wished to visit the registered provider’s office there are meeting rooms available on the ground floor. There is a car park for people to use and additional on street parking.   

This service has not had a registered manager in place since 13 August 2013. 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 the 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 provider has allowed a person who has not applied to become the registered manager to be in day to day charge of the service. They have a title of ‘project manager’. This person told us at the time of the inspection they had been there for two and a half years and had never intended to make an application to become the registered manager.

At this inspection we found a number of breaches of legal requirements which placed people at significant risk if harm. Some people had received inappropriate or inadequate care.

Staffing levels at times were inadequate. This meant that people did not receive safe care. Staffing levels reduce by fifty percent at weekends because staff had every other weekend off. There was poor staff rota management by the registered provider. Staff had zero hour’s contracts which allowed them to choose when they were available to work. The registered provider was unable to cover all the calls they needed to undertake over one weekend, 29 May 2015. People did not receive safe care and treatment and were placed at risk of harm. Three people had their calls missed. One person was found on the floor when staff from another registered provider called to visit them, and two had not received their medicines. Corrective action was not taken in a timely way by the management team to help protect people. The registered provider does not have systems in place to make sure that the service provision is not affected to this level again.

Annual training had not been completed for thirty seven percent of staff. The registered provider had not ensured that this training was completed in a timely way. Therefore people being supported in their own homes were attended to by staff whose skills were not up to date. Some people received inadequate care and support which affected their health and wellbeing. Some staff used poor infection control and moving and handling techniques which placed people at risk of harm. Staff were not supported to deliver care to people safely and to an appropriate standard.

People’s care records were not up to date to help inform staff of the care and support people needed to receive.

Medicines were not always handled safely. People did not always have their medicines when they were prescribed. This was because some rostered calls by staff to people in their own homes did not occur. One person had the wrong medicine patches applied. This meant that people received inadequate support with their medicines which placed their health at risk.

Staff understood they had a duty to protect people from harm and abuse. They knew how to report abuse to the local authority or to the Care Quality Commission [CQC]. However, some staff delivered inadequate care to people and not all of the required notifications had been sent to the Commission. There are twelve concerns about abuse and improper treatment which are being investigated.

The registered provider had some audits in place; however these audits had not been effective in highlighting the problems that we found during the inspection. There was a lack of management oversight into the quality of the service provided to people and incidents, accidents and complaints had not always been identified, reviewed or improvements made as a result. We concluded that the service was not well-led.

We found overall that people who used the service were at significant risk of receiving inappropriate or unsafe care. We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to: staffing, good governance, safeguarding service users from abuse and improper treatment and safe care and treatment. There were also two breaches of the Care Quality Commission (Registration) Regulations 2009 for failure to notify incidents and failure to have a registered manager in place.

Where we have identified a breach of a regulation during inspection which is more serious, we will make sure action is taken. We will report on this when it is complete. The quality rating of this service is inadequate, therefore this service has now been placed in special measures.