Archived: Friends Care Limited

Updated 3 August 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 checked 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 11 and 17 June and was announced with 48 hours’ notice being given. The inspection was carried out by two inspectors.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider returned the PIR within the set time scale. Before the inspection, we looked at information about the registration of the agency and notifications about important events that had taken place at the service. A notification is information about important events, which the provider is required to tell us about by law.

We spoke with the provider, administrator and three care staff. We visited three people in their own homes and obtained feedback from three social care professionals and one health care professional.

During the inspection we viewed a number of records including three care plans and daily notes, eight staff recruitment records, staff training, staff induction programme, supervision notes, policies and procedures, complaints logs, medication administration records and quality assurance questionnaires.

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Updated 3 August 2015

The inspection took place on 11 and 17 June and was announced. We gave ‘48 hours’ notice of the inspection, as this is our methodology for inspecting domiciliary care agencies.

In December 2013 the provider registered with us to provide a domiciliary care service. The service was located at Canterbury Enterprise Centre. In December 2014 the service moved to its current location at Marshwood Business Park. However, the service was not registered with us until 17 March 2015. This is the first inspection of the service at its location at Marshwood Business Park.

Friends Care Limited provides personal care and support to people in their own homes in Canterbury and surrounding areas. At the time of the inspection it provided a personal care service to three older people.

The service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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. At the time of this inspection, the provider was managing the service. In the absence of a registered manager, the provider was undertaking this role, but they did not have the skills, knowledge or experience to do so.

There was not an effective system in place to assess and monitor the quality of the service. There were no formal checks in place to ensure that staff had received effective training, that there training was up to date, that medicines were administered safely or that care plans and assessments were comprehensive.

There was a risk of people not receiving their medicines as prescribed by their doctor because there were not effective systems in place for the management of medicines. Staff had only received on-line training in how to administer medicines and had not been observed by a competent person to make sure that they were giving and recording medicines safely. Medication administration records were unclear so it was not possible to ensure that people were receiving the right medicine at the right time. No one employed at the agency had a comprehensive knowledge of the management of medicines and there were no formal systems in place to check if medication errors had been made.

Staff had not undertaken comprehensive training, nor had their competency been assessed by a qualified person, to ensure they had the required skills and knowledge in essential areas such as how to move and handle people safely, how to administer first aid and fire safety. Staff were helping one person to transfer and move and had not received practical training or written or verbal guidance in how to do so safely. Four weeks previously, the administrator had qualified as an assessor in how to move and handle people. However, staff who supported people to move, had not received any practical training, nor had their competency to move and handle people safely been assessed.

Staff had received training in how to safeguard people, but it was not effective in giving them the knowledge and competence in recognising the signs of abuse. The provider did not have a comprehensive understanding of what constituted potential abuse.

Staff and the provider had not received training in the Mental Capacity Act 2005. They were unable to tell us anything about its principles or how it affected their practice. The Mental Capacity Act aims to protect people who lack mental capacity, and maximise their ability to make decisions or participate in decision-making.

Assessments of risks had been undertaken in relation to the person’s home environment. However, action to minimise potential risks to people had not always been undertaken nor had guidance been provided to staff in relation to how to minimise risks that had occurred.

People’s needs had not been assessed by a person who did not have the required level of skill and knowledge to do so and as a result they were not always comprehensive. Some people required assistance with personal care, but this was information was not contained in their initial assessment. Plans of care did not contain detailed guidance for staff in how to move and handle people safely.

Before staff worked at the agency some checks were carried out, including identity and criminal record checks. However, for two staff no references had been recorded to check that they were suitable to work with the people that they supported.

There was not an effective complaints procedure in place. A serious concern raised by one person who used the service had not been identified or recorded as a complaint and as a result no action had been taken to this person’s concerns.

Staff knew people’s routines, preferences and family life. People said staff were kind and caring. At the time of the inspection people were supported by regular staff. However, one person had been supported by six different members of staff in the first six week of their care package, which did not result in continuity of their care. Most people said that they were treated with dignity and respect. However, some people who used the agency had not had their privacy and dignity respected and this had resulted in one person leaving the agency.

Staff received supervision, but most did not feel supported in their role. Staff worked alone and had little or no contact with other members of the staff team. There were no agency policies in place to give them guidance in areas of their work.

People’s needs in relation to food were assessed, and one person was encouraged to drink adequate amounts of fluid to keep them healthy.

Staff knew to contact the provider if they had any concerns about a person’s health. One member had called an ambulance when the person who used the service was seriously ill on arrival at their home.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated activities 2014).

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

Services placed in special measures will be inspected again within six months. The service will be kept under review and if needed could be escalated to urgent enforcement action.