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Inspection report

Date of Inspection: 9 December 2013
Date of Publication: 16 January 2014
Inspection Report published 16 January 2014 PDF

Staff should be properly trained and supervised, and have the chance to develop and improve their skills (outcome 14)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by competent staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 9 December 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service and talked with staff.

Our judgement

People were not always cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Reasons for our judgement

We spoke with three people who lived in the service. One person said, “Yes the staff seem well trained. They support me the way I want.” Another person said, “The permanent staff are well on. The regular staff are ok.” This person told us that when agency staff were on duty they did not feel so safe as when the permanent staff were working. They could not remember how frequently the agency staff were working or when the last time had been.

We spoke with the manager about this and they told us that in April and May 2013 the service was using agency staff. They had tried to ensure that these staff were as consistent as possible. The manager told us that since then they had recruited to support worker vacancies and increased the numbers of bank staff by four. They told us that this had limited the amount of agency staff and they had used one agency member of staff in the last month. This meant the service had taken steps to ensure that people who lived there experienced consistent staffing.

We spoke with three members of staff. One staff member said, “You get lots of training. You shadow before you work on your own. There’s no training I need that they don’t provide.” Another told us that they had worked in another service for three days in order to shadow people in a similar job role to their own. They said, “I did lots of training while I was there like moving and handling, medication and safeguarding.”

We spoke with a visiting healthcare professional who told us they had visited the service on a couple of occasions. They said, “So far the staff seem to know what they’re doing. I’ve had no complaints from the people I visit.”

One member of staff we spoke with said, “I feel supported 50/50.” They told us the area where they did not feel supported was with care plans and that as the system had recently changed they felt they needed more support to produce these. We spoke with the manager about this and they said they would look into the issue.

We looked at the files of two staff who started work with the service in October 2013. We saw that they were working through a comprehensive induction workbook which had been started prior to their first day with the service. This meant that staff new to working with the service were supported in their role.

From the staff training matrix we saw that mandatory training identified by the organisation included manual handling, infection control, fire safety, medication and safeguarding. We found that four staff were overdue with their refresher training in fire safety. We observed that all other mandatory training was up to date.

We found that staff had undertaken some training specifically linked to the needs of people who lived in the service such as diabetes, nutrition, PEG feeding (Percutaneous Endoscopic Gastrostomy (PEG) this is how a person is able to eat through a tube inserted directly into their stomach) and challenging behaviour. However there was no evidence of training being available for pressure area care. The manager told us that the organisation was currently considering the provision of training around pressure area care. This meant that the provider could not always be sure that all staff were suitably trained to meet the needs of the people living in the service.

From the three staff files we viewed, we found that two members of staff started work with the service on 1st October 2013. We saw that one of these members of staff had received supervision. From the other file, which was for a long standing member of staff, we saw that they had received no supervision during 2013, but an annual appraisal had been completed. The supervision policy and procedure for the service stated that all staff should receive supervision three times a year and one appraisal annually. The manager told us that not all supervisions had been carried out due to lack of capacity at management level but that this had now been rectified by recent recruitment. We spoke with one member of