Background to this inspection
Updated
21 September 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the 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 announced comprehensive inspection took place on the 14 August 2018. The inspection team consisted of one inspector and two new inspectors who were shadowing.
As part of the inspection process we looked at information we already held about the provider. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and the improvements they plan to make. We reviewed other information we held about the service to aid with our inspection planning. This included past inspection reports and notifications. A notification is information about important events which the service is required to send us by law.
We also contacted other health and social care organisations such as representatives from the local authority contracts and quality team and Healthwatch to ask their views about the service provided. Their views helped us in the planning of our inspection and the judgements we made. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
During our inspection visit, we met and spoke with two of the people who used the service. We spoke with one relative to get their views. During our visit to the office we spoke with the provider’s representative, the registered manager, one duty manager and six care staff.
We sampled care documentation for three people, medicines records, three staff files, staff supervision, appraisal and training records. We also looked at other records relating to the management of the service including audits, quality monitoring systems and action plans; accident and incident records; surveys; meeting minutes and complaint records.
Updated
21 September 2018
This inspection took place on 14 August 2018 and was announced. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. The inspection team consisted of one inspector and two new inspectors who were shadowing.
Pinner Court is registered to provide the regulated activity of personal care. This service is a domiciliary care agency [care at home]. It provides personal care to people living in their own homes within a retirement complex (The providers housing scheme). It provides a service to older adults. There were seven people using this service at the time of our inspection, one person was in hospital and one person was on holiday.
Not everyone using Pinner Court receives the regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.
At the last inspection in August 2017, we judged the service as requires improvement in the key questions of safe, effective and well-led and we rated the service Requires Improvement overall. During this inspection we identified two breaches of Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We were concerned because the provider had failed to ensure their recruitment procedures were robust and their quality monitoring systems continued to require improvement.
This inspection took place on 14 August 2018 to follow up on our previous findings. During this inspection the service demonstrated to us that improvements have been made and we identified that in some areas further were needed. We found the service was now meeting the regulations.
There was a registered manager in post at the time of the inspection. 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.
People were protected from the risk of abuse because staff were aware of the action to take if they suspected abuse had occurred. Staff were also aware of the provider's whistle blowing policy and told us they would use it if they had concerns. People told us there were sufficient staff deployed by the service to meet their individual needs. The provider followed safe recruitment practices when employing new staff. People told us staff followed safe infection control practices. The registered manager had taken some steps to improve the management of medicines but further were needed.
People told us care staff had the skills and knowledge to care and support them effectively. Staff told us they received regular training based on the needs of people using the service. People were asked for their consent before care was provided and the decisions they made were respected. Staff had received training on the Mental Capacity Act (2005) and they supported people to have maximum choice and control of their lives and support them in the least restrictive way possible. People were supported with their dietary needs and support to maintain their health and wellbeing, when necessary.
People were supported by caring staff that protected their privacy and dignity. People had support to make decisions and choices about their care and maintain their independence.
People had been involved in the planning of their care and were supported by staff in line with their individual needs and preferences. People knew how to complain and expressed confidence that the provider would address any issues they raised.
Some action had been taken to improve the systems used to check and audit the quality of the care provided at the service. However, further improvement was needed. The service had not monitored incidents effectively to reduce the risk of repeat occurrence. Staff felt well supported in their roles. There was a culture of openness and honesty and staff felt able to raise concerns or suggestions. People and staff felt supported and were confident in the management of the service.