Archived: Firstpoint Homecare Coventry

About the service

Firstpoint Homecare Coventry is a domiciliary care service providing personal care to children, younger adults and older people who have learning disabilities or autistic spectrum disorder, mental health diagnoses or dementia. At the time of our inspection the service was undergoing significant change and was reducing the number of people they supported. On our first day of inspection the service was supporting 115 people with personal care. By the second day of our inspection this had reduced to 22 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

The provider had arranged the reduction in people supported by the service in conjunction with the local authority. Firstpoint Homecare had a contract to provide personal care to people arranged and funded by the local authority.

In early 2019 there had been a large increase in the number of people supported by the service which was arranged by the local authority. The provider acknowledged that they had not been able to manage the care of the increased number of people safely or effectively.

In May 2019 the provider had met with the local authority and gave notice to end the contract, at this point Firstpoint Homecare Coventry was providing support to approximately 200 people. Since May 2019 the provider has worked with the local authority to transfer people to other care providers and the intention was by the end of August all local authority care packages would be moved to other care providers.

On 30 August 2019 Firstpoint Homecare Coventry was supporting 22 people who intend to stay with the service as privately funded clients.

People’s experience of using this service and what we found

On day one of our inspection we found risks to people’s safety were not always identified by the provider. This meant staff did not always have information available to support people safely. People did not always receive their calls at the expected time and some calls were not attended at all.

We asked the provider to take action to improve the information available to staff about individual risks and to provide daily reports about when care calls were provided. The provider took immediate action to ensure information available to staff about risks was reviewed, updated and available. They also ensured measures were in place to ensure prompt action was taken in the event of missed or late calls.

People were supported by staff who understood how to recognise and identify abuse however the provider did not always follow their policies to protect people when concerns were raised. We brought two incidents to the provider’s attention. In response to this, the provider immediately took appropriate action to safeguard people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us staff had the right skills and training to support them however we had identified occasions when staff had not supported people in line with their training . The provider had recently reviewed how new staff were trained and introduced a longer period for new staff to work alongside more experienced colleagues. This enabled the new member of staff to get to know the person they would be supporting.

People told us staff were caring and supported them in a respectful way. However, prior to our inspection we were informed of concerns raised by people when staff had not acted in a caring way. These incidents had been referred to the local authority to be investigated.

People told us they were not always supported by the same staff who they knew. The provider had already identified this and was working to improve the consistency of staff attending calls. People were involved in planning their care and had this information provided to them in a format they could understand.

People were asked for their feedback of the service, but this was not always used by the provider to drive improvement of the service. Due to management changes at the service people were not aware who the current manager was but they felt they could ask to speak to a manager and concerns would be acted on.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (Published 27 April 2019)

Why we inspected

The inspection was prompted in part due to concerns received about missed calls and the quality and safety of care provided. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Caring, Responsive and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

The provider has taken action to mitigate the risks identified and which has reduced the risk to people supported by the service.

Enforcement

We have identified breaches in relation to managing risks to people, taking appropriate action to safeguard people, monitoring process to ensure high quality care and failure to report incidents to us at this inspection.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service: People told us they received a good service and felt safe. Accidents and incidents were recorded and analysed, and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been appropriately trained. Arrangements were in place for the safe administration of medicines.

People and family members told us staff were usually on time and they generally saw the same regular staff. The provider had an effective recruitment and selection procedure in place, and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

People’s needs were assessed before they started using the service. Support plans were written in a person-centred way. Person-centred means ensuring the person is at the centre of any care or support and their individual wishes, needs and choices were considered

The service was responsive to people’s changing needs and people were supported to access the local community.

The provider had a complaints procedure in place, and people were aware of how to make a complaint. An effective quality assurance process was in place. People and staff were regularly consulted about the quality of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection: At the last inspection the service was rated Good (August 2016).

Why we inspected: This was a planned inspection. It was scheduled based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Firstpoint Homecare Warwickshire is a domiciliary care agency that provides personal care and support to people living in their own homes. Care staff call at people’s homes to provide personal care and support at set times agreed with them. The agency also provides ‘live in’ care services. At the time of our inspection there were around 45 people who received personal care through the agency.

During the inspection we met with the 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.

People told us they felt safe when supported by staff. Staff understood how to protect people from abuse and knew about risks to people’s safety. They told us they reported any concerns they had to the registered manager or staff based in the office so they could be acted upon. This ensured potential risks to people were managed appropriately. Staff were provided with a handbook containing the provider’s policies and procedures and were required to attend regular training so they knew what was expected of them when delivering care.

Staff received training on how to manage medicines safely. People told us staff mostly prompted them to take their medicines to make sure they took them.

Recruitment checks were carried out prior to staff starting work to ensure their suitability to work with people who used the service. New staff completed induction training and shadowed more experienced care staff to help develop their skills and knowledge. Staff also had regular supervisions with their manager to check their on-going competence to deliver safe and effective care.

People received a service based on their personal needs. All personal care calls were supported by two staff who arrived together usually within the timeframes agreed. People were positive about the staff who supported them and the care they received and said they were not rushed. People said staff maintained their privacy and dignity and supported their independence where possible. Where people needed assistance with meals, this was provided to ensure people’s nutritional needs were met.

The registered manager understood the principles of the Mental Capacity Act (MCA) and how to put these into practice. Staff told us they gained people’s consent before giving care.

The provider had systems and processes to monitor the quality of the service and to understand the experiences of people who used the service. This included quality satisfaction surveys and periodic reviews of people’s care. People we spoke with said they had no complaints about the service. Where concerns had been raised with the registered manager, these had been taken seriously and investigated.

We found overall that records were not always sufficiently detailed to demonstrate systems and quality monitoring were fully effective.