9 December 2015
During a routine inspection
The service was registered to provide personal care to people in their own home. The service registered with us in July 2014 and had been providing care for people since December 2014. This was the first inspection. At the time of the inspection the service was providing care to three people who all lived in the same house.
There was a registered manager at the service. 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 registered manager had been managing the service since 21 October 2015.
When people first started to use the service they and their families and not been supported to claim all the benefits available to them, In addition proper processes were not put into place regarding people’s tenancy of their home and their rent payments.
Staff were aware of how to keep people safe from harm and were clear on the processes to report any incidents which caused them concern to the provider and external agencies. Staff were aware of the risks to people while receiving care and provided care to keep people safe. However, the risks were not always fully identified in care plans.
People’s medicines were available to them when needed and stored safely. However, care plans did not contain information to support staff to consistently administer medicines prescribed to be taken as required and staff training around administering medicines was not robust. Staff told us that they were supported by the manager and had received some training. However there was no ongoing training in place to ensure staff skills remained up to date.
The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. The provider has systems in place to ensure people were supported to make decisions where they were able to and that more complex decisions were made in the person’s best interest.
The provider had systems in place to ensure staff had background checks completed to ensure they had the appropriate skills and experience to care for people. However, the provider did not ensure staff had contracts of employment. Records showed that there were enough staff to care for people safely and that people’s identified one to one support needs were covered. However, the registered manager had identified that extra staff were needed to provide cover for holidays and sickness and were working on enlarging the staff group.
People were supported to make choices about their meals and to make and eat meals together. A four week set menu was in place for the evening meal which had been agreed up on by all the people using the service. However, information in the service including care plans was not presented in a format which was accessible for people using the service and supported them to make choices about their care.
People’s one to one support was flexible and provided at times which allowed them to maximise their access to the community. Staff knew about people’s individual needs and care was provided to ensure people’s needs were met.
The provider had systems in place to engage people in the development of the service. In addition they worked with the local authority to improve the care provided to people. However, systems to monitor the quality of the service provided had failed to identify concerns with risk assessments.