Archived: Caring With A Difference Ltd

At the time of the inspection, the service was providing care and supporting 44 people and had 22 care workers working for them.

There was a registered manager in post. 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.

At our last inspection on 4 March 2016, the service did not meet Regulations 9, 11, 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found risks to people’s needs were not assessed appropriately, people were at risk of not receiving their medicines safely, people’s level of capacity had not been assessed, care records were not person centred and auditing processes were not robust enough to monitor and improve the quality of the service. This meant the quality rating we awarded was requires improvement.

After the inspection, we received an action plan from the service telling us what action they would take to meet legal requirements.

At this inspection the registered manager was able to demonstrate that measures had been put in place since the last inspection to respond to the issues identified.

Care plans were personalised and included information about people's preferences. However care plans were poorly presented and there was a lack of attention to detail. Information was not clear for staff to be able to know how to support people with their needs.

Although there some instances of lateness, overall people using the service and relatives told us that care workers turned up on time and they had regular care workers. The service had a system in place to monitor care workers punctuality.

Care workers spoke positively about their experiences working for the service. Training enabled care workers to have the necessary knowledge and skills they needed to carry out their roles and responsibilities.

Care workers had a good understanding of and were aware of the importance of treating people with respect and dignity. Feedback from relatives indicated that positive relationships had developed between people using the service and their care workers and people were treated with dignity and respect.

Systems and processes were in place to help protect people from the risk of harm. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse. Risk assessments had been carried out which highlighted potential risks and measures to ensure people were safe.

Arrangements were in place in respect of the management of medicines. Care workers had received medicines training and policies and procedures were in place.

The service had a complaints procedure and there was a record of complaints received.

Staff were informed of changes occurring within the service through regular staff meetings. Staff told us that they received up to date information and had an opportunity to share good practice and any concerns they had at these meetings.

Systems were in place to monitor and improve the quality of the service. We found the service had obtained feedback about the quality of the service people received through satisfaction surveys. Records showed positive feedback had been provided about the service.

At the time of the inspection, the service was providing care and supporting 65 people and had 20 care workers working for them.

There was a registered manager in post. 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.

Individual risk assessments were completed for each person. However, the assessments contained limited information and some areas of potential risks to people had not been identified and included in the risk assessments

There were some arrangements to manage medicines safely and appropriately. The Registered Manager told us care workers mostly prompted as people were able to their own medicines. However some people’s care plans indicated that people could be confused or disorientated but

care plans did not include any information about the support people may require with their medicines and how this was going to be managed and recorded. The registered manager told us they would review their medicines management

Care plans were not person centred and did not reflect the appropriate support people would need in relation to sometimes complex health and mobility needs.

There were some arrangements in place to obtain, and act in accordance with the consent of people using the service. However care plans did not contain any information about a person’s mental capacity and levels of comprehension especially for those people who suffer from memory loss and are unable to verbally communicate. Care workers had not received any training on the Mental Capacity Act (MCA).

The current systems in place were not robust enough to monitor and improve the quality of the service being provided to people using the service. Areas of concern found during this inspections had not been identified by the service.

Training records showed staff received regular training for them to gain the necessary knowledge and skills they needed to carry out their roles and responsibilities effectively.

People using the service and relatives told us they felt the care workers were sufficiently trained to provide the care and support people needed.

Feedback from people and their relatives indicated that people were being treated with dignity and respect.

People using the service and relatives told us the registered manager and office staff were approachable and easily contactable.

Appropriate checks were carried out when staff were recruited.

We found five breaches 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 this report.