Archived: Solace Community Care Limited

At our previous inspection on 4 August 2017 we found the provider was meeting regulations in relation to the outcomes we inspected.

At the last inspection, the service was rated Requires Improvement.

At this inspection, the service was rated Good.

Solace Community Care Limited is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to mainly older adults. It was providing a service to 32 people at the time of this inspection. Not everyone using Solace Community Care Limited receives regulated activity; 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.

A director of the provider organisation told us they intended to apply for registration, the service had been without a registered manger since June 2016. 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 and their relatives told us that they were happy with the service. They said they felt safe when care workers supported them with personal care. They reported that they were treated with kindness and compassion and care workers respected their privacy and dignity.

Appropriate support was provided if people needed assistance with medicines.

People said that care workers attended on time and if they were running late or had to be replaced, they were kept informed. The provider employed enough care workers to meet people’s needs and had thorough recruitment checks in place.

Care workers received induction when they first started in their roles and thereafter received refresher training on a yearly basis. Their competency was tested through assessments that were carried out after each training module. Records showed that care workers were up to date with training.

Staff had received training in the Mental Capacity Act 2005 (MCA) and understood the importance of asking people for their consent before supporting them with personal care. Where people were not able to consent to their care, the provider worked with relatives and health professionals in people’s best interests to ensure they received appropriate support.

A care co-ordinator completed an assessment of people’s needs, including any risks and the support they required before people began to use the service. Care plans were developed in line with these assessments. Peoples risk and care packages were reviewed regularly.

People told us they were confident if they raised any concerns these would be acted upon.

Although people told us they felt satisfied with the service in general, the lack of a registered manager and continual change in the office based staff meant that some quality assurance checks were not being carried out.

We undertook this focussed inspection to check that they had followed their plan and to confirm that they now met the legal requirements in relation to the breaches found. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Solace Community Care Limited on our website at www.cqc.org.uk.

There was no registered manager in post at the time of the inspection. The director told us they were recruiting for the 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.

Solace Community Care Limited provides domiciliary care for older people and for those with learning and physical disabilities. There were 37 people using the service at the time of our inspection.

At our previous inspection we found that some risk assessments were not completed properly and care workers were not accurately recording the medicines they supported people with. We found that staff recruitment procedures were not always robust, staff training was not always appropriate and staff supervisions were not taking place regularly. We also found that the provider was not meeting its legal requirements with respect to submitting notifications about certain incidents and checks to monitor the quality of service were not always in place.

At this inspection, we found that improvements had been made in all of these areas.

All risk assessments and care plans had been reviewed since the last inspection. Control measures were in place to manage areas identified as high risk. However we found that some areas could be improved further to give care workers more information about managing risk.

Medicine record logs were in place which meant care workers recorded the medicines that people were supported with appropriately.

Care plans had been reviewed to capture more person centred information about people and their preferences.

All staff files had been reviewed to ensure they had appropriate references. All care workers had undergone refresher mandatory training since the last inspection. An up to date training matrix was maintained and training records were retained. A schedule of staff supervision was in place and all care workers had received at least one supervision session since the last inspection.

The provider had undertaken work to remind care workers of their responsibilities in recording any incidents and accidents that took place whilst they were delivering care. This included discussion at team meetings and at individual supervision meetings.

Spot checks had been carried out which helped to ensure people were supported appropriately and feedback sought from people about the quality of service they had received.

Solace Community Care Limited provides domiciliary care for older people and for those with learning and physical disabilities. There were approximately 50 people using the service at the time of our inspection.

There was a manager at the service. However, they were not registered with the Care Quality Commission at the time of the inspection and were in the process of completing their application. 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 majority of people using the service told us they were happy with the service, however we identified a number of areas for improvement.

The provider was not following its own guidance in relation to safe staff recruitment. Staff recruitment checks were not thorough and did not always include appropriate reference checks to ascertain the suitability of new recruits. We could not be assured that care workers received regular, ongoing training to enable them to meet people’s needs effectively as training records showed that training was not always refreshed in line with the provider’s policy. Staff supervisions and appraisals were not carried out in accordance with the provider’s own policies.

Risk assessments were mainly focussed around risks in the environment and less in relation to people's support needs. They did not adequately identify assessed risks and risk management plans were not always in place to manage risks and keep people safe. Care records did not always document identified risks to people.

Although people did not raise any concerns about the support they received with medicines, support with medicines was not recorded in a way that promoted people’s safety and ensured that people received their medicines as prescribed.

Care records were not person centred and contained minimal information about people's preferences and how they liked to be supported.

People were given information how to raise a complaint should they choose to do so.

There had been no recorded complaints about the service.

Quality assurance checks such as surveys were completed but some checks such as unannounced spot checks were not carried out with any degree of regularity.

We found breaches of the regulations in relation to safe care, fit and proper persons employed, staffing, notifications and good governance. You can see what action we have told the provider to take at the back of the full version of this report.

The provider had amended the way they assessed risk to people using the service. The risk assessments were individual to people using the service. The provider had carried out an up to date risk assessment on all the people using the service. We saw that where risks had been identified, care plans had been developed to try and reduce these risks from occurring in future.

The provider had carried out unannounced spot checks and sent a quality assurance questionnaire to every person using the service. Where concerns had been identified, action plans had been put in place to try and ensure these were followed up.

We looked at seven records of people using the service. They contained a care plan and a risk assessment. Although risk assessments for people using the service had been carried out, they were not specific to the individual needs of the people using the service.

We looked at six files and training records of staff. Staff that we spoke with told us they had completed a National Vocational Qualification (NVQ) Level 2 in Health & Social Care whilst in employment with the provider. The manager told us that all the care workers were either enrolled onto a course to complete their NVQ level 2 or had completed it already.

There was a lack of quality monitoring checks that were carried out by the provider. This included spot checks and also checks on the daily care records of people using the service.

People's personal records, staff records and other records were accurate and fit for purpose. We looked at five care plans for people using the service and four staff files. These had all been updated recently. The manager told us that the new care plans "makes it easier for care workers to find out the needs of the service user quickly".

Records were kept securely and could be located promptly when needed.

The provider told us that they were in the process of reviewing their care plans to make them more person centred and individual. One relative told us "the care plan has been reviewed twice since last year". We saw evidence that some risk assessments related to falls had not been completed.

We saw records of staff training which showed that staff had recently attended training in safeguarding vulnerable adults. Safeguarding was also covered in the induction training plan for new members of staff. We spoke with relatives of people using the service who told us they felt confident leaving their family member with the care workers.

Relatives of people using the service told us they were satisfied with the care workers that were employed. One person told us "the quality of the carers is good".

Although people's records were kept securely and could be located promptly when needed, they were not accurate and fit for purpose.