28 and 30 October 2014; 5 November 2014
During a routine inspection
Sanctuary Home Care Limited (Devon Branch) provides personal care and support to people living in their own homes in Plymouth, North and West Devon. At the time of our inspection, 132 people were receiving care in North and West Devon and 124 people were receiving care in Plymouth and surrounding towns.
The service has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are responsible for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
At the time of our last inspections in December 2013 the provider had two registered offices, one in Plymouth and one in Barnstaple. The Barnstaple office service coordinated care for people living in North and West Devon. It was previously inspected on 5 December 2013 and we did not identify any concerns with the care provided. We also inspected the service coordinated by the Plymouth office which provided care to people in the Plymouth area on 10 December 2013 and found the service was meeting all the essential standards we assessed.
On 12 September 2014, the provider deregistered the Plymouth office. Since that date, the provider has coordinated care in the Barnstaple office for people living in the Plymouth area as well as those in North and West Devon.
We found there were not always enough staff to ensure people received their care at the time they expected. On a few occasions, staff did not turn up and therefore people were unable to receive the support they needed and there was increased risk to their wellbeing. For some of these people, this had meant they had not received their care at the time they should have. The provider was taking action to address these concerns by recruiting additional workers including staff who would be able to provide care quickly if a member of staff was absent without notice.
People said that they had complained about staff not always turning up and new staff, who they had never met, providing care. They commented that despite making a complaint the problems had not been resolved to their satisfaction and on occasions the same problems reoccurred.
Staff were not receiving supervision and appraisals as frequently as the provider’s policy identified they should. This meant that they were not being supported well to ensure that they delivered high quality care. The provider said that they had recruited supervisory staff which meant that they were expecting to address this. The provider had some quality assurance systems in place including monthly audits, although we found that these had not always been completed in the last twelve months.
The quality assurance systems assessed the services provided in North and West Devon, but not in the Plymouth area.
People’s needs were assessed and there were care plans to address these needs, however care plans were not always reviewed in line with the expected review date. People said they had been involved in the development of their care plans. They also said the staff were very caring and always treated them with kindness, compassion and respect.
The provider had systems to ensure that before staff started providing care to people, appropriate employment checks were undertaken and staff received training to support them in their role. However we found one staff file that didn’t have appropriate references. Staff were aware of their responsibility to protect people from harm or abuse. They knew what action they should take if they identified concerns about the safety or welfare of a person. They said they would be confident reporting any concerns they had to the registered manager. Records showed the provider had taken appropriate action when there had been a concern.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.