Archived: Communicare

The service provides support to 65 people living in their own homes, who may be living with dementia, have a physical disability or a sensory impairment and misuse drugs or alcohol. The support can be with personal care, food provision or personal safety.

The registered provider was required to have a registered manager in post. On the day of the inspection there was no registered manager, but the position of manager was filled by a registered manager and director of a company called Keymen Associates Limited, also registered with The Care Quality Commission (CQC). This person was also the Nominated Individual.

A registered manager is a person who has registered with the CQC 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 manager explained to us that the company Tom McCarthy Limited was now owned by Keymen Associates Limited. However, our checks with Companies House revealed there that the two companies were still independent of one another. They were also still separately registered with us at CQC, each having one ‘location’ (sites from which the businesses were operated).

As we had received no applications to de-register Tom McCarthy Limited, to add a new location (Communicare) to Keymen Associates Limited or to add a new location to the registration of the manager, we were unable to state that there was a registered manager at Communicare. CQC requested and received information to evidence that Keymen Associates was the ‘holding company’ for Tom McCarthy Limited, but there had been no registered manager at Communicare since February 2016. The manager explained to us that the location address of Communicare was soon to be changed and it was likely that by the New Year 2017 the service will have moved to another address.

All of this meant that the service could only be rated as 'requires improvement' for the section on Well-led. However, by the time we published the report for this inspection as a final document on our website, the registered provider had submitted applications to add Communicare location (at its current address) as a new location of Keymen Associates Limited and to add that location to the registration of the manager filling the position at Communicare. These applications were processed and therefore the service now has a registered manager.

People were protected from the risk of harm because the registered provider had systems in place to manage safeguarding incidents. Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of managing safeguarding concerns. Risks were managed and reduced on an individual basis so that people avoided injury or harm.

Staffing numbers were sufficient to meet people’s needs and we saw that rosters accurately cross referenced with the support workers on duty. Recruitment policies, procedures and practices were followed to ensure staff were suitable to care for and support vulnerable people. We found that the management of people’s medicines was safely carried out.

People were cared for and supported by qualified and competent support workers. Workers were supervised and took part in an appraisal scheme regarding their personal performance. Communication was satisfactory but people we spoke with told us it could be better from the office workers, in respect of information to people about changes in support workers or lateness of calls. People’s mental capacity was appropriately assessed and their rights were protected with regard to ensuring their liberty. Support workers had knowledge and understanding of their roles and responsibilities in respect of the Mental Capacity Act (MCA) 2005 and they encouraged people to make decisions for themselves. People were supported with nutrition and hydration where necessary.

We found that people received appropriate care from kind support workers who knew about people’s needs and preferences. People were involved in aspects of their care and were asked for their consent before support workers undertook care and support tasks. People’s wellbeing, privacy, dignity and independence were monitored and respected and support workers were determined to maintain these wherever possible. People were supported according to their support plans, which were regularly reviewed and amended according to need and/or requests.

There was an effective complaints procedure in place and people had complaints investigated without bias. People that used the service, relatives and their friends were supported to maintain healthy relationships.

We saw that the service was well-led in all aspects, except that there was no registered manager in post. People had the benefit of an open and inclusive culture and the management style of the service was positive. There was an effective system in place for checking the quality of the service using audits, satisfaction surveys, meetings and good communication. Information from the quality monitoring and assurance system had been used to take action and make changes to the service for people but this had not been fed back to anyone who used the service or other stakeholders.

People were assured that recording systems used in the service protected their privacy and confidentiality as records were well maintained and were held securely in the company premises.