4 April 2016
During a routine inspection
Housing and Care 21 DCA (Sheffield) is a domiciliary care service. The agency office is based in Sheffield. They are registered to provide personal care to people in their own homes throughout the city of Sheffield.
The service was last inspected on the 08 September, 01 and 02 October 2015 and was found to be in breach of five regulations at that time. Regulation 18: Insufficient staff were employed to cover care. People employed by the service did not receive appropriate supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform. Regulation 12 :People were not receiving their medicines when they needed them because visits were missed. Medicine risk assessments had not been reviewed. Regulation 13:The safeguarding file didn’t contain details of all current safeguarding referrals. CQC checked and found that Housing and Care 21 (HC21) did not always notify CQC of safeguarding concerns, or take steps to identify any issues, patterns or trends. A warning notice was issued for this. Regulation 9: People did not always receive person centred care and treatment that was appropriate and met their identified needs. Regulation 17: Systems were not in place to ensure an accurate and contemporaneous record in respect of each service user was maintained. Systems were not in operation to assess, monitor and improve the quality and safety of the services provided in the carrying on of the regulated activity.
The provider sent a report of the actions they would take to meet the legal requirements of these regulations. The action plan received from the provider showed all actions would be completed by March 2016.
We undertook this inspection so we could look at whether the provider had made progress in meeting these regulations.
It is a condition of registration with the Care Quality Commission that the service has a registered manager in place. 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 manager had been in post since January 2016 and had applied to register with us.
Significant changes to the staffing at HC21 had occurred since our last inspection. The registered manager and members of the senior staff team had left the agency. The provider had put interim management arrangements in place to support the operations and on-going improvement of the service.
All of the staff and most people spoken with reported improvements to the agency in recent weeks.
People spoken with said they had regular care workers that they knew well. People told us their regular care workers were kind, caring and considerate. They told us they felt safe with their regular care workers.
The provider did have adequate systems to ensure the safe handling, administration and recording of medicines to keep people safe.
Staff recruitment procedures were thorough and ensured people’s safety was promoted. The provider had undertaken all the checks required to make sure people who were employed at HC21 were suitable to be employed.
The provider had recruited permanent care workers to ensure they had sufficient numbers of suitably deployed staff.
Although there had been improvements there were some staff who had outstanding training requirements and some staff had not received supervisions or appraisal.
Staff were provided with relevant induction support and training to make sure they had the right skills and knowledge for their role.
People’s care plans were person centred and contained information on the support needed and risks to the person to ensure people’s needs and preferences were reflected. For example, we found information in care records regarding people’s life histories and preferred past times and interests. This meant information to provide personalised and person-centred care was made available for staff to read.
Most people felt staff were caring and respected their privacy and dignity. However there were examples where this was not the case.
Some people felt complaining did not improve the service they received as any concerns they raised weren’t responded to or acted upon. People told us they did not always get a response when they telephoned the agency office.
There were some systems in place to assess and monitor the quality of service provided. The provider had an improvement and action plan that showed audits had taken place to measure improvement and identify further actions needed to continue improvements. However sufficient time had not yet passed to see if this was embedded into practice.