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Carrington Home Care Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 28 February 2019

This announced inspection took place on 10, 15 and 24 January 2019. We gave the service 48 hours’ notice of the inspection visit. This is because it is a small domiciliary care agency and the provider works as part of the management team. Carrington provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. Not everyone using Carrington Home Care receives a regulated activity. The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’. This includes help with tasks related to personal hygiene and eating; we also consider any wider social care provided.

At the time of our inspection, the service was providing personal care and support to 38 people living in their own homes. The last CQC inspection took place in June 2016 when it was rated as Good. However, on this inspection we judged improvements were needed in how the provider managed and ran the service. The provider has registered with CQC as an individual and therefore does not require a registered manager.

There were aspects of the service which were not well led. The registered provider had not carried out regular quality assurance audits to ensure the service was providing good quality care.

During our inspection, we found a number of areas needed to improve to maintain the safety and well-being of people; these had not been addressed by the provider. Quality assurance systems were not effective in recognising areas for improvement and there was not a timely response to initiate changes.

People were supported by staff who treated them with kindness, respect and compassion. Staff had a good understanding of the people they cared for and supported them in decisions about how they liked to live their lives. People were supported by staff who respected them. However, there were gaps in staff training and records relating to observations of staff practice and supervision.

People said the staff made them feel safe because they were kind and reliable. The management team understood their safeguarding responsibilities. Staff ensured there was a consistent approach to involving people with their care plans.

Systems in place for the recruitment and selection of staff were poorly managed by the provider. They did not ensure new staff had appropriate documentation in place to confirm they were suitable to work with people using the service. Recruitment checks were not routinely carried out before staff started their employment at the agency.

Action was needed to improve medicine training and auditing staff practice to ensure they worked in a safe manner. Potential risks to people’s health and well-being were assessed and documented.

Equality and diversity was understood to support people’s individuality. There were systems in place to gain people's views and to address concerns and complaints. People were supported to access health care professionals to maintain their health and wellbeing. The service was reliable and staff understood the importance of good infection control practice.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.

Inspection areas

Safe

Requires improvement

Updated 28 February 2019

The service was not always safe.

People were not protected by robust recruitment practices. However, people said staff made them feel safe.

Poor documentation meant the provider could not demonstrate medication practice was safe.

The service was reliable and staff understood the importance of good infection control practice.

Staff understood their safeguarding responsibilities.

Effective

Requires improvement

Updated 28 February 2019

The service was not always effective.

Staff inductions, supervisions and training were not well managed. Staff did not receive regular training to cover all aspects of their role to ensure the support they were delivering was safe and effective.

Steps were not consistently taken to ensure people’s legal rights were protected.

People were supported to maintain good health and had access to appropriate services, which ensured they received on-going healthcare support.

Caring

Good

Updated 28 February 2019

The service continued to be caring.

Responsive

Good

Updated 28 February 2019

The service continued to be responsive.

Well-led

Requires improvement

Updated 28 February 2019

The service was not well led.

There was a lack of oversight by the provider regarding auditing and reviewing how training and recruitment were managed.

The overall governance of the service needed improvement. Quality assurance systems had not been fully developed to regularly monitor the service and assess the care provided to people.