21 and 22 April 2015.
During a routine inspection
This was an announced inspection which took place on 21 and 22 April 2015. We made telephone calls to speak with people using the service and staff working for the service on 23 April 2015. This was the first inspection of this service, although it had previously operated under a different name and registration. Most of the staff and many of the service users had transferred across to the new service.
Prestige Homecare is registered to provide personal care to people living in their own homes. At the time of our inspection there were 55 people using the service and eight care staff employed to deliver the service. People told us they felt safe with the staff who supported them and they also spoke positively about the caring nature and attitude of the staff.
Prestige Homecare 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 registered manager was also the owner of the service.
We identified six breaches of 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 this report.
Staff who we spoke with told us that they had received no training since the service had moved to the Marple office and, at the present time, felt the registered manager was ‘no longer approachable or very supportive’.
Staff rotas indicated that staff were working a lot of hours in one week to make sure that the contracted hours with the local authority were being met.
Care plans contained limited information to support staff to deliver safe and effective care to those people using the service. Risk assessments had not been completed by Prestige Homecare in relation to peoples individual and assessed needs.
We found that the registered manager had limited understanding of the principles of the Mental Capacity Act (MCA) 2005 and our discussions with staff also indicated they were lacking a clear understanding of how to ensure people’s right to make their own decisions were being upheld.
People using the service told us that the care being provided was responsive to their needs and that regular contact was maintained by the registered manager.
Appropriate records had not been maintained in the office for all the people using the service.
A system was in place to record and respond to any complaints raised about the service and most of the people we spoke with told us they would be confident enough to approach the staff or registered manager with any concerns.
The registered manager told us that they carried out random monthly checks of service user files, staff rotas, care plans and reviews. Although there were ‘tick sheets’ that had been signed by the registered manager there were no details about what information had been checked in the records. We found that there was no structured and meaningful audit process in place for the service. This had resulted in many of the shortfalls and breaches of regulations we found during the inspection process.