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Oasis Care and Training Agency (OCTA) Requires improvement

Reports


Inspection carried out on 18 February 2020

During a routine inspection

About the service

Oasis Care and Training Agency (OCTA) is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to younger disabled adults and older people, some living with dementia. 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.

At the time of the inspection the provider was supporting 115 people in the London Boroughs of Greenwich, Lambeth and Croydon with personal care.

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

People and their relatives were positive about the kind and friendly support they received from their care workers, who had a caring attitude, even when there were varying levels of communication. One person said, “They are always respectful. They ask if they can do anything else for me before they go and they will always help me with things I find difficult.”

Assessments recorded detailed information about people’s preferences to ensure they received personalised care. Care plans included visit summaries for care workers to follow and staff had a good understanding about how people liked to be supported. We saw the provider tried to be flexible when needed to accommodate people’s changing needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People were supported by a committed staff team that praised the support they received from the management team and were positive about the caring and inclusive working environment. Many staff had worked for the provider for a long time and spoke of a ‘welcoming family environment.’

Although there were monitoring processes in place, these were not always effective and did not pick up the issues we found during this inspection.

The provider was aware of this and staff were regularly reminded about their key responsibilities to ensure people’s needs were met and any necessary improvements could be made. One care worker said, “We are all here to support people and our common goal is to improve the service across the whole team.”

A health and social care professional praised the service on how they worked hard to meet people’s needs, especially those with more challenging social and complex issues.

Improvements were needed to ensure people received their medicines safely.

We have made a recommendation that the provider ensures safer recruitment processes are always followed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 10 August 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified one breach in relation to medicines management. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 4 July 2017

During a routine inspection

Oasis Care and Training Agency is a domiciliary care service, which provides personal care to people in their own homes in 14 London boroughs. At the time of the inspection there were about 216 people using the service.

The service was inspected on 31 August and 2 September 2016, where we found the service was in breach of two regulations of the Health and Social Care Act 2008 (Regulated Activities) 2010. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Oasis Care and Training Agency OCTA’ on our website at www.cqc.org.uk.

We undertook a focused inspection on 7 February 2017 in relation to the breaches of regulation we identified at our previous inspection of September 2016. We found that the service had followed their action plan and had made the required improvements. We could not however change the rating for the key questions ‘Is the service safe?’ and ‘Is the service well-led?’ because to do so required a record of consistent good practice.

We undertook an announced comprehensive inspection on 4 July 2017. We gave the registered manager 24 hours’ notice as we needed to be sure they would be available for the inspection. At this inspection we found that the service had sustained the improvements put in place following our previous inspections of September 2016 and February 2017 and met the legal requirements.

The service had 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 ‘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.

Staff handled and administered medicine to people in a safe way. Staff had been trained in the safe administration of medicines and they understood and followed the organisation’s medicines policy. Risk assessments were carried out and management plans were in place to keep people safe from avoidable harm. Recruitment procedures were safe to ensure only suitable personnel worked with vulnerable people. Staff understood how to recognise signs of abuse and how to protect people from the risk of abuse.

Staff understood their responsibilities within the Mental Capacity Act 2005. Staff were supported through induction, supervision, appraisal and training to provide an effective service to people. People were supported to eat and drink appropriately and to meet their dietary and nutritional requirements. People were supported to arrange appointments to ensure their health needs were met. Relevant professionals were involved to ensure people received appropriate support and care that met their needs.

People told us staff treated them with kindness and respected their dignity. Staff understood people’s needs, preferences and cared for as they wanted. People and their relatives were involved in their care planning and these were reviewed and updated regularly to reflect people’s changing needs. Staff encouraged and enabled people to do what they can do for themselves to keep them active and maintain their independence.

People and their relatives were given opportunities to share their views about the service. People knew how to complain. The registered manager investigated and responded to complaints and concerns appropriately.

Regular spot checks and audits were carried out to identify shortfalls in the service.

Inspection carried out on 7 February 2017

During an inspection to make sure that the improvements required had been made

Oasis Care and Training Agency is a domiciliary care service, which provides personal care to people in their own homes in eight London boroughs. At the time of the inspection there were 321 people using the service.

We carried out an unannounced focused inspection of this service on 31 August and 2 September 2016 and we found three breaches of regulations. The provider wrote to us to say what they would do to meet the regulations. We received action plan from the provider stating how they would meet our regulations.

We undertook this announced focused inspection on 7 February 2017 to check that they had followed their plan and to check that they now met the regulations inspected. The provider was given 48 hours' notice because the location provided a domiciliary care service and we needed to be sure that someone would be in.

This report covers our findings in relation to those requirements. You can read the report from our last focused inspection, by selecting the 'all reports' link for Oasis Care and Training Agency on our website at www.cqc.org.uk.

At this focused inspection we found the service had implemented comprehensive procedures to ensure the safe recruitment of staff. Staff personnel records contained two references, photographic identification, proof of address and a disclosure and barring services (DBS) record. Where staff had criminal convictions, the service carried out risk assessments to assess their suitability to deliver care and support. Recommendations identified in risk assessments were adhered to.

The service had a registered manager in place. 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.

This focused inspection took place on 7 February 2017 and was announced. The provider was given 48 hours' notice because the location provided a domiciliary care service and we needed to be sure that someone would be in.

At this focused inspection we found the service had implemented comprehensive procedures to ensure the safe recruitment of staff. Staff personnel records contained two references, photographic identification, proof of address and a disclosure and barring services (DBS) record. Where staff had criminal convictions, the service carried out risk assessments to assess their suitability to deliver care and support. Recommendations identified in risk assessments were adhered to.

People were protected against the risk of harm and abuse. Staff were supported to receive regular safeguarding training, to aid them in recognising the different types of abuse and the correct procedure in reporting suspected abuse. Records showed staff’s understanding of safeguarding was regularly reviewed through supervisions.

People were supported by a service that learned from accidents and incidents. The service recorded incidents and accidents, and took appropriate action in reporting these to relevant professional bodies. Audits of accidents and incidents were undertaken to ensure trends were identified and action taken to minimise the risk of repeat incidents.

People’s complaints were documented and action taken to address their concerns in a timely manner. Records showed complaints were logged centrally and documentation relating to concerns and complaints remained confidential. The service kept records securely to ensure only staff with authorisation had access to confidential records.

Inspection carried out on 31 August 2016

During a routine inspection

Oasis Care and Training Agency is a domiciliary care service, which provides personal care to people in their own homes in 14 London boroughs. At the time of the inspection there were 374 people using the service. The service had a registered manager in place. ‘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.’

Prior to the inspection the CQC had been informed of a concern about an aspect of the service. This was being investigated by other agencies at the time of the inspection. CQC will continue to monitor the progress and outcome of this investigation.

This inspection took place on 31 August and 2 September 2016 and the inspection was announced.

The provider was given 24 hours' notice because the location provided a domiciliary care service and we needed to be sure that someone would be in.

We last inspected the service on 14 and 23 March 2016 and the service was meeting all areas inspected.

People were not always protected against the risk of unsuitable staff. The service did not have robust employment practices. Staff files did not always contain two references and references did not always reflect people’s work history. Records showed that the service did not have adequate systems in place to ensure they had suitable disclosure and barring services [DBS] certificates in place. Where concerns about criminal records were identified, action to ensure people’s safety was not robust or well documented.

People were not always protected against the risk of harm and abuse because the service did not have robust vetting practices in place when employing staff. Staff were aware of the different types of abuse and how to report suspected abuse. Staff had received safeguarding training and were aware of the service whistleblowing policy.

People were at risk as the service did not have robust auditing systems in place. Audits relating to medicines, employment and records did not identify concerns in a timely manner.

People were at risk of unsafe medicine management. The service did not have robust systems in place to ensure people received their medicine in line with good practice. Medicine Administration Recording [MAR] sheets were not always completed correctly. People’s dose, and route of medicine was not always clearly documented.

People were aware of how to raise concerns and complaints, however their concerns were not always recorded appropriately. Staff kept notebooks of concerns and complaints raised, which were not always kept securely in a locked office. The service did not have adequate storage and filing systems in place to ensure records were kept securely and easily obtainable.

People were protected against identified risks. The service had risk assessments in place that identified the risk and gave staff guidance on how to minimise and mitigate the known risk. Risk assessments were reviewed regularly to reflect people’s changing needs. Staff were aware of the importance of reporting any concerns regarding risks to their supervisors.

People received care and support from staff that received on-going training to enhance their skills and knowledge. People received a comprehensive induction that followed the care certificate from skills for care. Staff were shadowed by an experienced staff member, to ensure they were competent in their role prior to lone working.

Staff and the registered manager were aware of their role and responsibilities in providing support to people within the principles of the Mental Capacity Act 2005 [MCA]. People’s consent was sought and respected prior to care and treatment being delivered. Staff were aware of the importance of seeking people’s consent. People were supported to access health care

Inspection carried out on 14 March 2016

During an inspection to make sure that the improvements required had been made

We carried out an inspection of the service on 25 & 26 November 2014. At which time breaches of legal requirements were identified. This was because the provider did not ensure the safe management of medicines, carry out audits of identified risks and care plans were not regularly reviewed.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on14 and 24 March 2016 to check that they had followed their action plan and to confirm that they now met legal requirements.

This report covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Oasis Care and Training Academy on our website at www.cqc.org.uk

This inspection took place on 14 and 23 march 2016 and was announced. We gave the provider 48 hours notice of our visit so that they could arrange for people to be available to talk with us about the service.

Oasis care and training academy provides personal care to people in their own homes in the boroughs of Lambeth and Southwark.

There was a registered manager in place. 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 supported to receive their medicines in line with their prescriptions. Staff received regular training on the safe management of medicines. People were protected against known risks. The service had comprehensive risk assessments in place to ensure identified risks were mitigated.

People’s care plans contained comprehensive information including their medical history, likes and dislikes and health care needs. Care plans reflected people’s current health needs and gave staff clear guidance on how to meet people’s care needs. Care plans were reviewed regularly and updated to reflect people’s changing needs.

People were supported by a service that carried out regular reviews of the care and support provided.

An audit and compliance team undertook reviews of staff time keeping to ensure any delayed or missed calls were acted upon immediately. Audits undertaken ensured that live documents were reviewed regularly to reflect changes.

Inspection carried out on 25 and 26 November 2014

During a routine inspection

This inspection took place on 25 and 26 November 2014 and was announced. When we last visited the service on 7 October 2013, the service was meeting the regulations we looked at.

Oasis Care Agency provides support including personal care for people in their own homes. At the time of the inspection about 100 people were using the service.

The service had 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 ‘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.

Medicines were not always handled and managed safely. Information about the management of people’s medicines was not always clearly and accurately recorded and there were inconsistencies in the practices of staff. This meant people may not always have the support they required with their medicines.

Risk assessments did not always cover people’s specific health and conditions. There were no individualised risk management plans to ensure that risks associated with people’s health and well-being were managed safely.

The service was not regularly assessed and monitored to ensure the quality of service provided to people was effective and met their needs and care plans were not always reviewed and updated to reflect changes in people’s needs.

Recruitment procedures were robust and safe. Staff understood how to recognise abuse and protect people from the risk of abuse. People, their relatives and staff were encouraged to provide feedback and to raise concerns. Concerns were investigated and responded to appropriately to keep people safe and to improve the service.

The service worked closely with healthcare professionals. People were supported to arrange appointments to ensure their health needs were met. Relevant professionals were involved to ensure people received appropriate support and care in relation to their health needs.

Staff understood the principles of the requirements of the Mental Capacity Act 2005 and supported people with their decisions. Staff were supported through effective induction, supervision, appraisal and training to provide an effective service to people.

People said staff treated them with kindness and respect. People were supported to eat and drink appropriately. Staff provided support to people the way they wanted to be cared for. The service was flexible in meeting people’s needs.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we have told the provider to take at the back of the full version of this report.

Inspection carried out on 7 October 2013

During a routine inspection

We spoke with 11 people using the service and four relatives on the telephone. Seven people using the service and eight relatives completed questionnaires we sent to them.

There were positive comments about the care workers and the service in general. A relative of a person using the service said, �They provide a very valuable service with good humour and dedication.� People said that their care workers were caring and respectful and knew them well. One person said, �She is so respectful and so caring. I never have to tell her what to do she knows what to do which is a godsend.�

Staff understood their responsibilities to safeguard vulnerable adults. The medication policy had been revised and the frequency of care worker training increased to enhance the protection of people using the service against the risks associated with medicines.

Oasis has its own training centre and provides training for its care workers, including English classes, to enable them to provide care safely and to an acceptable standard. We saw that care workers had regular supervision with their line managers.

Oasis regularly evaluated the quality of the service they provided. People who provided feedback told us the office responded promptly to any concerns. One of them said, "They have good communication. I would be happy to ring at any time if I wasn�t happy.�

Inspection carried out on 17 May 2012

During a themed inspection looking at Domiciliary Care Services

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies with particular regard to how people's dignity was upheld and how they can make choices about their care. The inspection team was led by a CQC inspector joined by an Expert by Experience, who has personal experience of using or caring for someone who uses this type of service.

We visited four people in their home and spoke with them and their relatives about the support they had received from Oasis Care and Training Agency (Oasis). We also talked by telephone with 14 people who use the service and two of their relatives. The people we spoke with said the care workers were caring and pleasant and many said they were able to chat and have a laugh with them. One person said, �She is an angel�, and another said, �They treat me very well�.

Four family members we spoke with were very appreciative of the responsiveness of the care workers to their relative�s cultural and language preferences. People also appreciated having the same care workers, who knew what they needed and how they liked things done.