This inspection took place on 22 April 2016 and was announced. Carepoint Services is registered to provide personal care and support to people living in their own homes. At the time of the inspection there were 136 people using the service.
The service has a registered manager. 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 last time we inspected this service in September 2014, we found a breach in relation to the management of people’s medicines. We found that people did not have a medicine risk assessment in place when required. People did not receive their medicines as prescribed. There was no medicine audit in place to identify and manage medicine errors promptly. We issued a Warning Notice for these breaches of the regulations. We asked the registered provider to send us a plan for improvements to meet the regulations. However, we did not receive the action plan requested.
At this inspection, we followed up on the outstanding breaches. We found evidence of improvements in some areas. There was a medicine audit tool in place and there were medicine risk assessments in place for people. However, we found there were continued breaches in relation to the management of medicines.
The management of people’s medicines were not safe. We found that there were unexplained gaps in people’s medicine administration records (MARs) therefore people were at risk of not receiving their medicines as prescribed. People who required support with their medicine management were not included on the medicine audit. People did not receive their medicines safely because staff did not follow up concerns about people’s ability to manage their medicines promptly.
People and their relatives did not have a formal way of giving feedback to the registered manager. This meant that people could not give their views on the service. The registered manager sent out annual feedback forms to people or their relatives after the inspection.
Staff protected people from harm and abuse. The registered provider had safeguarding processes in place for staff to follow to raise an allegation of abuse. Staff identified monitored and managed risks to people’s health and well-being.
There were sufficient numbers of staff to provide care and support to people. The registered provider’s recruitment processes were robust and identified only suitable and skilled staff to be employed. However, we found there were no processes in place to request renewed work permits to ensure staff maintained the right to work in the UK. We have made a recommendation in the report.
The registered provider had a training programme in place that allowed staff to obtain skills and knowledge. However these records showed that staff did not have access to regular training. The registered manager explained the suspension of staff training was because the service focussed on other areas of the service and therefore training for staff did not happen. Staff had an induction, supervision and appraisals that provided them with the opportunity to explore their professional practice.
Staff cared and supported people within the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) principles. The MCA supports people who lack the ability to make specific decisions for themselves. Staff were aware of how to care and support people that protected their rights within the values of MCA. This was because staff had completed MCA training and applied their knowledge to their daily practice. Staff supported people to consent to care by giving them choices to enable them to make decisions about their care.
People’s care and support was delivered by staff with kindness and compassion. Staff worked with people in a way that respected their dignity and privacy. Staff managed people’s care and support needs, which demonstrated staff, knew people well. Health care services were sought when people’s care needs changed. People had access to meals that staff prepared which met their individual preferences and nutritional needs.
People contributed to their assessment of need and were involved in developing a plan of care that met those needs. People were able to make choices about the care they received through the registered provider’s assessment process. People were supported to raise concerns and complaints.
The registered manager monitored and reviewed the service to make improvements to the quality of care provided. The registered manager was aware of their responsibilities as registered manager with the Care Quality Commission.