Archived: Cyprian Care Limited

Updated 19 September 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.

What we did before the inspection

Before the inspection we reviewed the information we already held about this service. This included details of its registration, previous inspection reports, notifications of serious incidents and any whistle blowing or complaints we had received. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We spoke with 10 people and 12 relatives of people who used the service about their experience of the care provided. We spoke with 15 members of staff including the registered manager.

We reviewed a range of records. This included 14 people’s care records and eight people’s medication records. We looked at five staff files in relation to recruitment and staff supervision. We also looked at a variety of records relating to the management of the service, including policies and procedures.

Updated 19 September 2019

About the service

Cyprian Care is a domiciliary care agency that provides personal care to people living in their own homes. At the time of our inspection the service was supporting 165 people.

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

We found that medicines were not always managed in a safe way, the service did not appropriately respond to and report on allegations of abuse to keep people safe and accidents and incidents were not analysed to prevent recurrence.

The service did not always provide staff with supervisions in line with their policy. We have made a recommendation about the supervision frequency.

Care plans did not evidence that people were involved in the planning and reviewing of their care. We have made a recommendation about documenting people are involved in making decisions about their care.

Care plans did not ask questions about all the protected characteristics relating to equality and diversity. We have made a recommendation about discussing equality and diversity with people receiving care. Staff were not equipped with the skills to provide end of life care to people and people were not given a chance to discuss their end of life wishes. We have made a recommendation about end of life care being provided where appropriate.

The governance systems in place did not identify the shortfalls we found during our inspection.

People told us they felt safe with staff. People’s risks were recorded to ensure staff knew how to keep people safe. People were protected from the risk of harm associated with the spread of infection. There were enough staff working at the service and pre-employment checks were carried out on prospective staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Assessments were undertaken to determine people's needs before they moved into the service. Staff received training to support them in their roles. Staff were provided a thorough induction and ongoing training, to enable them to provide effective care and support. People's nutritional needs were met, and the service worked well with other relevant healthcare professionals.

People told us they were treated in a caring manner by staff. Staff understood how to support people in a way that respected their dignity, privacy and promoted their independence.

People received individualised care that met their needs. The care plans were person centred and discussed people's preferences. Information was provided to people in an accessible format. People told us they felt able to make a complaint and were confident that complaints would be listened to and acted on.

People and staff spoke positively about the service and said it was managed well. There were processes in place to manage and monitor the quality of the service provided. The management team had regular contact with people using the service and their staff. The registered manager kept up to date with best practice to ensure a high-quality service was being delivered.

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

Rating at last inspection

The rating for this service was good (published 11 January 2017). The service is now rated requires improvement.

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the safe, effective, caring, responsive and well-led sections of this report.

Enforcement

We have identified breaches in relation to safe care and treatment and good governance. 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 and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.