Archived: Hosanna Social Care Services

Hosanna Social Care Services is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection they were providing personal care to one person.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People were not protected from the risk of harm due to ineffective safeguarding systems. People were also not protected from the risk of harm connected with health conditions due to poor risk management systems. People did not always receive their medicines as prescribed. People’s health and nutritional needs were not always understood and met safely.

People were supported by sufficient numbers of care staff who were recruited safely. People were not always supported safely and effectively due to the registered manager and care staff not having the skills to recognise any deficiencies in care.

People were not supported to have maximum choice and control of their lives. We could not be certain staff supported them in the least restrictive way possible and in their best interests. The policies and systems in the service did not support good practice.

People were supported by a staff team who cared about them and had good intentions towards them. However, they were not always equipped with the skills and knowledge to recognise when care delivery was not always caring in nature. People’s privacy was respected although their independence could be promoted further.

People were not always empowered to be as fully involved with decisions about their care. Information was not always provided in an accessible format and they were not fully involved in reviews of their care.

People were not protected by effective management, quality assurance and governance arrangements. The provider and registered manager did not have a robust knowledge of current legislation, guidance and care standards. As a result they had not developed policies and processes that were of a good standard. They had also failed to recognise the deficiencies and areas of risk within the service.

Rating at last inspection

The last rating for this service was good (report published 07 October 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

At this inspection we have identified the provider was not meeting the requirements of the law in relation to safe care and treatment, safeguarding people, training and the governance of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.

There was a registered manager in post and she was present during our 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 and associated Regulations about how the service is run.

Staff were trained and knew how to report and deal with issues regarding people’s safety. We found that systems were not in place to ensure people received their medicines safely. However the registered manager took immediate action to address this to ensure people were safe. Staff were recruited in a safe way which ensured they were of a good character to work with people who used this service.

Staff had the relevant information about how to minimise identified risks to ensure people were supported in a safe way. Staff received an induction to ensure they had the skills and knowledge to support people in accordance with their needs and the values of the provider.

The registered manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Staff gained people’s consent before they provided support.

People received support from staff that were respectful and caring and ensured that people’s privacy and dignity was maintained. People were supported to maintain their health.

Relatives were happy with the service provided and thought it was well managed. Records were not in place to demonstrate how the service was being monitored in order to measure the quality of the service provided. The registered manager was unaware that staff were supporting a person with a medicine and therefore the appropriate safeguards were not in place.