Archived: ARRCC - The School Creative Centre

This inspection took place between the 7 August to 11 August 2017. Two days were spent at the providers office (7 and 8 August 2017) and following this additional time was taken to telephone people, their relatives and staff. This was an announced inspection. This means the provider was given notice due to it being a domiciliary care provider and we needed to ensure someone was available. The inspection involved visits to the agency’s office and telephone conversations with people and their relatives.

ARRCC - The School Creative Centre is a domiciliary care company based in Rye. They provide support and care for predominately older people living in their own homes. People using the services were at risk of falls and had long term healthcare needs such recovering from strokes and living with dementia type illness. ARRCC - The School Creative Centre provides services within an approximate 10 mile radius from their office in Rye. At the time of our inspection 10 people were using the service. The support offered by the ARRCC - The School Creative Centre often complemented pre-existing care packages provided by other care agencies. ARRCC - The School Creative Centre also offered domestic and social support and assisted people to access health care appointments.

There was an acting manager in post who was undergoing the registration process to become the providers registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Despite improvements with the care planning documentation and the risk assessments contained within them we found some people were awaiting having their records transferred on the new format. This meant that the previous shortfalls we found in the risk assessment process had not as yet been fully addressed and as such the provider could not be assured that clear risk management were available to staff.

Most people did not require support with their medicines and since our last inspections there had been improvements in the administration records available to staff associated with supporting people. However we found minor anomalies in how staff were completing this paperwork which meant there was a risk their recording may not be consistent.

Staff had an understanding of consent and respecting people’s choices and decisions. However we found there remained ongoing improvements with how routine best interest decisions were completed and recorded within care documentation.

The previous concerns identified at our last inspection related to people’s care plans had, in most cases, improved. However, there remained some care plans which did not always reflect the actual care people were being supported with. The acting manager was aware of these shortfalls and was working to ensure staff had appropriate and relevant information available to ensure people received person centred care.

The acting manager had not been consistently supported in their new role by the provider. We found examples where they needed additional direction, support and resources to ensure they were able to sustain improvements.

Care staff had been supported effectively through a supervision or training process. New systems had been established to ensure staff had access to a range of training designed to enable them to be able to support people in their own homes.

People were cared for, or supported by, sufficient numbers of staff. People told us they were supported by friendly, reliable and caring staff who respected their privacy and promoted their independence. People who needed it were supported to eat and drink enough and staff knew what to do if they thought someone was at risk of not eating or drinking sufficient amounts. People were supported with their day to day health care needs.

Audits were completed and the acting manager tracked all significant and no routine events to ensure any follow up actions were taken appropriately and in a timely manner.

ARRCC - The School Creative Centre is a domiciliary care company based in Rye. They provide support and care for predominately older people living in their own homes. People using the services were at risk of falls and had long term healthcare needs such recovering from strokes and living with dementia type illness. ARRCC - The School Creative Centre provides services within an approximate 10 mile radius from their office in Rye. At the time of our inspection 14 people were using the service. Approximately half the people using the service also regularly used other care providers. The support offered by the ARRCC - The School Creative Centre often complemented pre-existing care packages provided by other care agencies. ARRCC - The School Creative Centre also offered domestic and social support and assisted people to access health care appointments.

There was a registered manager in post, a registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Although people and their relatives spoke positively about the services they received from ARCC - The School Creative Centre we found the service was not well led. Senior staff did not have clear oversight of the service due, in part, to a lack of effective quality assurance systems. The shortfalls in the provider’s policies and procedures meant clear guidance was not available in areas such as mental capacity, safeguarding and medicines. Multiple examples of care documentation being incomplete or missing were identified during our inspection.

Risks associated with supporting people in their own home had not been clearly identified from either a care delivery or environmental perspective. Robust guidelines and systems were not in place with regard to safeguarding, and accident and incident reporting. Although staff were able to identify potential abuse the appropriate reporting channels had not been clearly established.

Staff had not been supported effectively by the provider in regard to their probation, or development through supervision or training. Training requests, made to the provider, by staff to enable them to better understand people’s conditions had not been supported. Gaps in staff knowledge was apparent in regard to the Mental Capacity Act (2005) where no training had been provided. We found there was an over reliance on care staff to identify changes to people’s risk level and care needs rather than the provider taking accountability.

Despite people telling us it was usual for them to be supported by staff who knew them well and were friendly; we found examples where staff had not treated a person with respect. Care documentation did not reflect people’s involvement in the care that was being provided. Care plans were basic, not person centred and task orientated and did not provide detail on how individuals could be best supported for each identified support need.

The provider had not assured they were meeting people’s needs as care documentation was not being routinely reviewed or updated and provided limited insight and guidance for staff into people’s support needs, personalities or likes and dislikes. From speaking with staff we found there were significant contrasts between actual care delivery versus people’s documented care records.

People were cared for, or supported by, sufficient numbers of staff. People told us they received a good level of continuity of care and felt care staff knew how to support them. A theme from people and their relatives was the service was flexible in their approach and due to the size of the agency there was a more personal service.

Staff said they enjoyed working for the provider and told us the range of work available made their roles interesting and varied.

We found breaches 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 this report.