Archived: Sturminster Newton - Care at Home

Sturminster Newton Care at Home is registered to provide personal care to people living in their own homes. At the time of our inspection the service provided personal care and support for 49 people. The core hours of the service were 7 am to 10 pm. There was a 24 hour on-call service available.

There was not a registered manager in 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. The previous registered manager had de-registered in December 2015. A new manager had been appointed and had applied to the Care Quality Commission to be a registered manager, their application was in progress.

People were positive about the care and support they received. They told us staff treated them kindly and we saw people engaged in conversations and light-hearted discussions. Staff demonstrated that they knew individual preferences. Care plans were person centred and took into account people’s social and personal histories so that care was individualised and represented what the person hoped to achieve.

People were supported to ensure they had enough to eat and drink and staff had an understanding of how some people needed to be encouraged to eat their meals. We saw staff monitored what some people ate where it was needed and actions taken to ensure people’s nutritional needs were met.

Staff were aware of what constitutes abuse and what actions they should take if they thought someone was being abused. Relevant checks were carried out before staff started work. For example references were obtained and criminal records checks were completed.

Medicines were managed safely. Staff had received training and there were monitoring systems in place to check people had received the correct medicines at the right time.

People’s risks were assessed and plans developed to minimise the risk of them coming to harm. There was sufficient guidance for staff to ensure they supported people safely. Such as one person was at risk of skin damage , there was detailed guidance for staff to support the person in such a way to reduce the risk of them developing skin damage.

Staff had an understanding of the requirements of the Mental Capacity Act (2005) and talked to us about how they supported people to make their own decisions. People were provided with choices about how they would like to receive care and support.

Management were committed to making continual improvements to the quality of care. This included a commitment to fostering community links such as dementia awareness and expanding what the service was able to offer people.

There were sufficient staff to ensure people received their visits as planned. People told us they mostly received visits on time and were contacted if the care worker was running late due to traffic or an emergency.

The quality of the service was monitored on an on-going basis through observations of staff during visits as well as consideration of accidents and incidents and feedback from people and staff.

Is the service safe?

People's care and treatment was planned and delivered in a way that ensured people's safety and welfare. Staff demonstrated a good understanding of the risks related to people's care needs.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We spoke with three people and four people's representatives who all told us that they were happy about how staff supported them or their relative with their medicines.

People were protected against the risks of unsafe care as people's care records were accurate.

Is the service effective?

Care provided followed people's care plans to ensure people's needs were met. People who used the service and their representatives told us staff were reliable, arrived on time and provided the care and support that they needed.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. We looked at the training records for twenty care workers and saw all training was up to date.

Is the service caring?

People were supported by kind staff. One person's representative told us, "I can't tell you how happy I am to have them (care for their relative)." Another person told us, "The staff are fantastic. They look after me very well."

Is the service responsive?

The service responded to changes in people's health and care needs. Care records showed that the agency had spoken with occupational therapists, district nurses and General Practioners (GPs) about people's needs. One person told us that staff had prevented a serious medical emergency as they had persuaded them to accept a GP visit as they were unwell.

Is the service well-led?

The provider had a system to regularly assess and monitor the quality of service. People we spoke with told us that the provider checked with them that the service met their needs and if they were happy with the service. The provider carried out unannounced monitoring visits on care staff to monitor the quality of the service. All staff that we spoke with told us that these checks took place on a regular basis.

The provider had made some improvements in the management of medicines but did not have appropriate arrangements in place to ensure that all medicines were administered safely. This meant that some people were at risk of not receiving their medicines as prescribed.

People were cared for by staff who were not supported to deliver care and treatment safely and to an appropriate standard. Staff told us that they did not receive regular supervision. The provider had an induction programme in place which was mandatory for all staff before they started working unsupervised with people who used the service. Not all staff had received ongoing training to help them to meet people's needs and keep people safe.

The provider did not have an effective system in place to manage risks to the health, safety and welfare of people using the service and others. We saw that there were two significant incidents in the last five months. There was no evidence that systems had been put in place to manage risks.

The provider had made some improvements since our last inspection in the completion of care records however people's care plans and risk assessments were not always accurate and fit for purpose. This meant that people were at risk of receiving inappropriate or unsafe care.

Care plans and risk assessments did not always detail how staff should meet people's needs but staff did understand how to meet people's needs.

Medication was not always handled correctly and accurate records of administration were not always maintained.

The provider carried out sufficient pre employment checks and people were cared for, or supported by, suitably qualified, skilled and experienced staff.

People's views and experiences were sought to improve the service. Systems to regularly assess and monitor the quality of service that people received did not always identify areas for improvement.

Records were not available for all people therefore people were not protected from the risks of unsafe or inappropriate care and treatment.