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Archived: Penwith Care Requires improvement

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Reports


Inspection carried out on To Be Confirmed

During a routine inspection

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 carried out on 25, 28 July 2014

During a routine inspection

We carried out this inspection as a response to receiving information of concern in relation to the quality of care provided by this service. During our inspection of this service we considered our findings to answer our five questions; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence to support our summary please read the full report.

Is the service safe?

On the day of our inspection people who used the service were safe. People told us the felt safe with their care staff. People's comments included �I do get on well with them, I think they like coming here� and the staff �are very nice people�.

The provider had effective policies and procedures in place to ensure that people who used the service were adequately protected from the risks associated with the management of their medications.

People were, however, exposed to some unnecessary risks as pre-employment checks for new members of staff had not been completed. In addition risk assessments had not been completed for two of the six people whose records we inspected.

Is the service effective?

At the time of the inspection the service was effective. People told us the care they received was �brilliant, absolutely brilliant� and �everything I need, they do�.

We found that most people who used the service had detailed care plans that effectively directed and informed staff of people�s care needs, however, there was no care plan available in one of the files we inspected. Daily care records included sufficient information and accurately recorded the care provided to each individual.

Is the service caring?

We found that the service was caring at the time of our inspection. People told us the staff �are very nice people� and �fantastic people, great at every aspect of their job�.

Staff members told us they enjoyed their work and felt the service provided good care their comments included �I love it� and �I am really enjoying it�.

Is the service responsive?

At the time of the inspection we found the service to be responsive. We saw Penwith Care was in the process of conducting a survey of people who used the service and people told us �I�ve just had a survey to do, it had about 20 questions. This is the second one this year�. The previous survey completed in September 2013 had been positive and we saw that the service regularly received thank-you cards from people who used the service and their relatives.

We saw that issues reported to managers by staff and people who used the service had been effectively investigated and resolved. People who used the service told us they knew how to raise concerns with the management of the service, their comments included �I always go straight to the top one. She was her last week and told me to give her a ring if I needed anything� and �head of them came here yesterday�.

Is the service well led?

At the time of the inspection we found that the service was not well lead.

We saw that new members of staff had not received a formal induction and that established members of staff had not received supervision or appraisals.

Staff members told us �the manager is good at the job, amazing with clients but not as good with staff�.