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Archived: Penwith Care Requires improvement

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 16 September 2015

Penwith Care is a small domiciliary care agency which provides support to people in their own homes in and around St Ives Bay. At the time of our inspection Penwith Care was providing support to 32 predominantly older people.

This inspection took place on 24 and 26 June 2015 and was announced 24 hours in advance in accordance with the Care Quality Commission’s current procedures for inspecting domiciliary care services. The service was previously inspected in July 2014 when it was found to have failed to have complied with some of the requirement of the regulations. Staff had not received appropriate induction, training or formal supervision. In addition the service records were disorganised. Some people’s care records did not include any information about their care needs and some staff files and training records were missing.

The organisation was led by a registered manager who also owns the business. 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.

People were happy with the care they received from staff who they got on with well. People’s comments included; “they are good company we have quite good fun together”, “very pleasant ladies” and, “They [Staff] are all very nice and definitely look after me.”

The service had recently experienced a number of management challenges when a number of staff had resigned. Throughout this period the registered manager had endeavoured to ensure people’s care needs were met. Where the service was unable to meet people’s needs the registered manager had worked with commissioners to arrange for people’s care to be transferred to other providers.

Records demonstrated that low staffing levels had impacted on the timing of people’s care visits. During the week prior to our inspection we saw some visits had been provided over an hour early while other care visits had been over two hours late. People who used the service told us; “Mostly arrive within half an hour, they tend to be early at the moment” and, “not exactly to time but it does not matter”. Health and social care professionals commented, “they do their very best but sometimes they can be very late”. We found, however, that once staff arrived they normally provided the full length of planned care visits and we did not identify any incidents when the care visits did not take place.

Staff visit schedules showed staff regularly supported the same people and were able to develop caring relationships with the people they supported. People told us; I have the same carer all week” and, “They [Staff] are all very nice and definitely look after me.” While staff said; “I know all my client’s well” and, “my rota does not change much, I see the same people every week.”

The service was in the process of actively recruiting additional staff to enable the service to meet people’s care needs. However, the failure to complete necessary pre-employment checks or provide induction training before allowing staff to deliver care exposed people who used the service to unnecessary risks.

The registered manager had recognised they needed additional management support and a consultant had been appointed to act as the service’s deputy manager. The registered manager and consultant were aware of most of the areas of concern identified during the inspection and were in the process of planning how these issued could be resolved. Staff said, “the manager knows things need to change, which is why the consultant is here”.

Care plans were available for all of the people who received care and support from Penwith Care. Each person’s care plan was up to date and included sufficient information to enable staff to meet people’s care needs. Staff said the care plans were, “useful”, “good” and, “kept up to date”.

People’s feedback was valued by the service. Complaints had been appropriately investigated and resolved to people’s satisfaction. A survey was in progress at the time of our inspection and initial feedback people had provided was positive.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Requires improvement

Updated 16 September 2015

The service was generally safe. However, staff shortages and poor recruitment practices had exposed people to unnecessary risks.

Staff understood their role in relation to the safeguarding of adults and mangers ware aware of recent changes to the processes for the reporting of concerns to the local authority.

The service used it’s call monitoring system effectively to ensure that care visits were not missed.

Effective

Requires improvement

Updated 16 September 2015

The service was not effective. Staff had not received appropriate induction training.

The service had not consistently provided staff with the training they required and staff supervision had not been provided regularly. The registered manager was aware of these issues and had begun to take action to address these concerns at the time of our inspection.

Caring

Good

Updated 16 September 2015

The service was caring. People told us they got on well with the staff who supported them

People’s privacy and dignity was respected by staff and care plans included guidance for staff on how to support people to make decisions about the care they received.

Responsive

Good

Updated 16 September 2015

The service was responsive. People’s care plans were detailed and personalised. These documents contained sufficient information to enable staff to meet their identified care needs.

People knew how to raise complaints about the service and reported that any concerns they raised had been resolved appropriately.

Well-led

Requires improvement

Updated 16 September 2015

The service was not well led. Staff morale was low and a number of staff had recently resigned from the service.

The resignation of large numbers of staff had resulted in significant managerial challenges which the registered manager had dealt with appropriately to ensure people’s care needs were met.

Additional support for the registered manager had been commissioned from a consultant and staff recognised this was leading to improvements within the service.

The service quality assurance systems were not operating effectively as daily care records were not regularly returned to the office for review.