9 February 2017
During a routine inspection
Support at Home Great Yarmouth and Waveney provides support to people who require assistance with Saphena (anti-embolism) socks when they return home following surgery. Prior to fitting the Saphena socks volunteers supported with washing and applying cream to the area where the stockings would be fitted. As this involves personal care it is therefore a service which the Care Quality Commission (CQC) regulates.
The service was supporting two people in the Great Yarmouth and Waveney area when we inspected. From July 2016 to February 2017 the service had supported 7 people with their Saphena socks care. Support at Home Great Yarmouth and Waveney provided other volunteer services, however CQC do not regulate these. This report only relates to the Saphena sock care element of the service. People were supported by a group of volunteers. The service employed two coordinators and a manager. This was the service’s first inspection.
There was not a registered manager in place. 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. There had not been a registered manager for some time, although there was an acting manager.
When we contacted the service to announce our visit we were informed that the service was being provided from a different location to that registered with CQC. The provider had not informed us of this change and therefore the service was not registered correctly. We asked the provider to rectify this and shortly after this inspection CQC received an application from the provider to request changes to correct their registration.
The service was not monitoring the practice, skills, and knowledge of the volunteers who were performing the regulated activity, to ensure they were competent in this role.
The service was not completing internal audits to test the quality of the service. People’s risk assessments and records were not being audited. There was a lack of systems in place to always ensure the service responded appropriately to maintain people’s safety.
The provider’s audit had not identified all of the issues that we identified in this inspection.
These issues all contributed to a breach of Regulation 17 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 the report.
The service was not completing robust risk assessments for the people the service supported. Volunteers were expected to complete risk assessments when they started to visit people, but they did not have training about how to do this. People’s records did not demonstrate that people’s needs and the potential risks which they faced had been fully explored by the service.
Volunteers and staff received an induction to the service and had on going training provided on a regular basis. The volunteers spoke positively of the training they received. The volunteers, staff and the manager were motivated to provide good care to people.
Volunteers understood the importance of responding to concerns about people’s health. The service had a duty system to support volunteers. Volunteers said they felt confident to respond effectively in an emergency situation.
The volunteers demonstrated they understood how to protect people from the risk of abuse. Volunteers were aware of this potential issue and knew what to do if they had concerns.
People benefited from volunteers and staff who felt valued and important to the service. The volunteers spoke positively of the staff (coordinators) who supported them. They told us they found them approachable and supportive. The manager, staff and the volunteers had confidence in the service they were providing.
People said they saw the same volunteers at regular times and did not have missed care visits. People also told us that volunteers stayed longer at their care visits, if this was needed.
Volunteers understood the importance of promoting and protecting people’s dignity, privacy and independence. People gave many positive examples of the caring and empathetic approach of the volunteers who supported them. People told us they were treated with dignity and in a caring and kind way.
Volunteers had received training in the Mental Capacity Act 2005 (MCA) and demonstrated they understood the importance of gaining people’s consent, before assisting them.
People felt comfortable speaking with the volunteers and coordinators about any issues they had about the service. There was a complaints process in place for the service to respond to complaints.