Archived: High Level Care Limited

Updated 7 July 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. Because of the limited size of the service we have not awarded a rating in this instance.

This inspection took place on 7 April 2015 and was unannounced. We returned on 13 April 2015 for a second day to complete our inspection. We had received information about concerns in relation to the service, and as a result we brought the date of this planned inspection forward. The inspection was carried out by two inspectors.

Before the inspection we reviewed all of the information we held about the service and the service provider, in particular any of the notifications that had been sent to us. Notifications are sent to CQC to inform us of any legally notifiable events, such as accidents or safeguarding matters.

Prior to the inspection we contacted North Tyneside Council safeguarding team and North Tyneside Council contracts team to discuss their views of the service. We did not receive any information of concern from these teams.

During our inspection we spoke with one person who was supported by the service, one relative, and a care manager. We visited the main office for the service and looked at two people’s care records, seven staff personnel files and records relating to the management of the service. We spoke with the provider, the acting manager and four members of care staff. With their permission, we visited one person who used the service to discuss their views of the care provided and look at the records kept at their home.

Updated 7 July 2015

This inspection was unannounced and carried out on 7 April 2015. A second, announced inspection took place on 13 April 2015. The service had registered with the Care Quality Commission (CQC) in December 2014, and this was the first inspection.

High Level Care Limited is a domiciliary care agency which provides care and support to people in their own homes and in the community. Care is provided for people with physical or mental health needs. At the time of our inspection the service provided care for two people.

A registered manager had been in place and our records showed she had registered with the Care Quality Commission (CQC) in December 2014. However the provider told us that she had left the company approximately one month before our inspection. 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.

Staff had not received training in how to identify and respond to potential abuse. One member of staff told us about their concerns for a person using the service. We found this information had not been shared with the local authority safeguarding team which meant the provider’s protocol had not been followed. The acting manager of the service, and the provider told us they had not undertaken any safeguarding alerter training, about what to do if staff came to them with concerns, but said would arrange this training after our inspection.

Risks had not been properly assessed. We saw incorrect information had been recorded on some risk assessments and there were no assessments in place for risks associated with the activities people were supported to take part in.

People we spoke with told us the service was reliable and there were enough staff to meet their needs. However, robust recruitment processes had not been followed and staff had started working for the service, providing care to people, before checks had been carried out to determine if they were suitable to work in a caring role.

Staff had not completed any training whilst they had been working for the service. They had been provided with DVDs to watch and then expected to complete a questionnaire testing their knowledge on the training. None of these questionnaires had been completed at the time of our visit and the provider was unable to tell us how they ensured staff were competent to deliver care.

Staff had not received any supervision sessions. The acting manager told us these would be arranged for every three months, but that none of the staff had been in their roles for three months at the time of our inspection. Staff told us the organisation was supportive and they could contact the acting manager or provider with any concerns.

Staff, the acting manager and provider of the service had an awareness of the Mental Capacity Act 2005 (MCA) and were able to tell us about the way they followed the requirements of this law. Staff told us people had capacity to make all of their own decisions, including the right to refuse care if they wished. The person we spoke with confirmed that staff respected their wishes.

A range of assessments had been carried out to determine people’s needs. However, we saw when people’s needs changed these had not always been updated which meant they were not accurate.

The care delivered did not always match the care that had been planned. We saw staff did not follow a moving and handling assessment provided by an occupational therapist which meant people may have been at risk of receiving unsafe care.

The records we viewed as part of this inspection were not completed to a high standard. Care records were unnamed or undated. The acting manager and provider were unable to provide us with records or information during our inspection. They told us they had not recorded information.

Risks to staff had not been assessed and mitigating actions to reduce risks had not been put into place.

We found four breaches of regulations. These related to; Safe care and treatment, Safeguarding, Good governance and Fit and proper persons employed. You can see what action we told the provider to take at the back of the full version of the report.

Where we have identified a breach of regulation during inspection which is more serious, we will make sure action is taken. We will report on this when it is complete.