Background to this inspection
Updated
20 April 2016
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.
This inspection took place on 8 and 15 December 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available at the office.
The inspection team consisted of two inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert-by-Experience did not attend the office base of the service, but spoke by telephone with people who used the service and relatives of people that used the service.
Prior to our inspection, we reviewed the information we held about the service, which included notifications. Notifications are changes, events or incidents that the registered provider must inform CQC about. We contacted commissioners and asked them for their views about the service. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority.
We spoke with 19 people; this was a mix of people using the service and relatives of other people using the service. We spoke with the branch manager, training officer and seven staff.
We reviewed records held at the service’s office, which included four people’s care records to see how their care and treatment was planned and delivered. We reviewed three staff employment records and other records which related to the management of the service such as quality assurance, staff training records and policies and procedures.
Updated
20 April 2016
We inspected this service on 8 and 15 December 2015 and the inspection was announced. This meant the provider and staff knew we would be visiting the service’s office before we arrived.
Sterling Homecare (Derby) provides personal care and support to younger adults, children and older people living in their own homes in Derby and Derbyshire. This included people with learning disabilities or mental health. At the time of this inspection there were 66 people using the service, which included up to 25 people who received personal care.
There was a registered manager in post, who registered with CQC on 31 December 2015. 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.
People’s care was not being delivered in accordance with their care plan and did not ensure their safety. For example some people told us that their calls were sometimes missed altogether.
We found unsuitable arrangements in place to assess and monitor the quality of the service, so that actions could be put in place to drive improvement as required.
Risk assessments and care plans had been developed with the involvement of people. However these had not been reviewed at regular intervals to ensure they were current. Systems were in place to ensure people received their medicines in a safe way.
Staff treated people in a caring way. However staff did not always maintain people’s privacy and dignity.
Complaints were not always well managed and communication with the office had been inconsistent and not resolved issues satisfactorily.
Staff were able to demonstrate on how they would keep people safe. However we found that the provider did not have effective processes in place to ensure all safeguarding concerns were reported to all the relevant authorities in a timely manner.
Current staffing levels did not ensure that there were sufficient number of staff to meet people’s individual needs. Recruitment procedures were safe.
The branch manager and staff we spoke with understood the principles of the Mental Capacity Act 2005 (MCA). This included staff seeking consent from people before delivering care in accordance with their care plan.
Staff told us that they would alert health care professionals if they had any concerns about people’s health and they would inform the office staff if they were concerned about a person’s well-being.
People’s needs were assessed prior to the service being offered and they had been involved in assessments.
Where we have identified breaches of legal requirements and regulations associated with 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 the report.