Archived: Prosper Community Care

Prosper Community Care is a domiciliary care service providing personal care to people in their own homes in the Trafford area of Greater Manchester. At the time of our inspection they were supporting 56 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.

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

We found some people’s care plans did not include all the information needed for care workers to support people safely. People we spoke with told us they felt safe and that the registered manager was responsive to any concerns raised. People told us they saw regular care workers and felt protected from the risk of infection by the care workers. People were supported to take medicines at the appropriate times.

Governance systems in the service were not being operated effectively to ensure compliance with regulations and to assess and improve the quality and safety of the service. The registered manager had provided CQC with an action plan detailing improvements they were making but we found many of these had not been completed. The registered manager encouraged an open culture and people felt able to speak to him.

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 requires improvement (published 31 July 2019) and there were multiple breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made/ sustained and the provider was still in breach of regulations. The service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to the management of pressure area care and recruitment practices in the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained requires improvement. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Prosper Community Care on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the information available to care workers about how to support people safely, robust governance and quality processes, staff training records and recruitment records held by the service. We have written to the provider requesting further evidence to demonstrate their compliance with regulations.

Follow up

The provider is already making changes to their service. We will meet with the provider following this report being published to discuss progress against their action plan. We will work with the 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.

Prosper Community Care is a domiciliary care agency providing support to people in their own homes in the community, mostly in the Trafford area of Greater Manchester. At the time of our inspection they were supporting 34 people.

People’s experience of using this service:

Staff were trained in safeguarding people from abuse and the registered manager worked with the local safeguarding authority to investigate any concerns that were raised.

Checks were done on applicants before they started work however there was no process in place to ensure documents relating to staff were kept up to date.

Risks to people were assessed and where risks had been identified additional support plans were put in place to inform care workers how to support the person safely.

People were asked for their consent before they were supported. Where people lacked capacity to make decisions for themselves processes were in place to ensure decisions were made in the person's best interests.

People told us they did not always get a choice of meals. We saw this had been raised with staff by the registered manager to remind them of the importance of this.

Some people told us the carers were very caring but some people felt the carers did not communicate well.

People and their relatives felt involved in deciding how they wanted to be supported.

People were encouraged to be independent.

There was a lack of quality monitoring systems in place. Complaints and incidents were not analysed to identify if anything could be learned from the event to improve the quality of the service.

We have made a recommendation about how the service manages complaints.

The service met the characteristics of requires improvement in all areas and is therefore rated as requires improvement overall. More information is in the full report which is on the CQC website www.cqc.org.uk

Rating at last inspection:

At the last inspection the service was rated good (published 13 September 2016).

Why we inspected:

This was a planned inspection based on the rating of the service at the last inspection.

Follow up:

We have asked the provider to let us know what action they will be taking to improve the service to at least ‘Good’. We will continue to monitor the service through information we receive and future inspections.

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.

This was the first comprehensive inspection of the service following their registration with the CQC in July 2015.

Prosper Community Care Limited is registered with the Care Quality Commission to provide personal care to people living in their own home. At the time of our inspection seven people were using the service.

A registered manager was 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.

People who used the service and their relatives were complimentary and positive about the attitude and support of the care workers. They told us calls were never missed and where staff were unable to arrive on time the registered manager arranged for another care worker to attend the visit.

Care workers we spoke with told us they had undergone a thorough recruitment process. They told us training appropriate to the work they carried out was always available to them and following their employee induction. This helped to make sure the care provided was safe and responsive to meet peoples identified needs.

Care workers also confirmed they had received safeguarding and whistle blowing training and knew who to report to if they suspected or witnessed abuse or poor practice. Individual staff training records indicated that all care workers had received such training and were working towards a nationally recognised qualification in care such as a National Vocational Qualification (NVQ) in health and social care and the Care Certificate. This is a professional qualification which aims to equip health and social care staff with the knowledge and skills they need to provide safe care and support to people using the service. The care workers told us they also received regular supervision from the registered manager in the form of one to one meetings and on the job spot checks which helped them to carry out their roles effectively.

People were supported by sufficient numbers of suitably trained staff. We saw that recruitment procedures ensured staff had the appropriate qualities to protect the safety of people who used the service and we saw they received the training and support required to meet people’s needs.

A person using the service and their relative told us that the care workers treated them caringly, sensitively and with respect and they tried to make sure that their independence was maintained wherever possible.

Care records were in place to reflect people’s identified care needs. Information about how people wanted to be supported, their likes and dislikes, when support was required and how this was to be delivered was also included in the care records we examined. We saw written evidence of people and their relatives being involved in the decision making process at initial assessment stage and during their care needs review.

Medicines were administered by staff who had been given appropriate training to ensure that they were given safely.

Information regarding people’s dietary needs was included in their care support plan and guidance for care workers helped make sure these requirements were met. Any specific requirements in relation to medication, such as ‘to be taken with food’ were clearly documented so that care workers were aware of any risk.

Where people who used the service did not have the capacity to make their own decisions, the service ensured that decisions taken were in line with the principles of the Mental Capacity Act 2005. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

The provider had systems in place to monitor the quality of the service such as regularly speaking to people and their relatives about their satisfaction of the service provided. Announced and unannounced employee spot checks were in place and consisted of visits to people’s homes whilst staff carried out their care duties. This was done to check if people were happy and satisfied with the service they were receiving and to make sure care workers were carrying out their duties appropriately.

Complaints, comments and compliments were encouraged by the provider and any feedback from people using the service and their families was shared through face to face meetings with the manager. Any feedback received was used to make improvements to the service and the care and support being provided.

All of the people spoken with knew how to make a complaint and felt confident to approach any member of the staff team if they needed to. We saw evidence that people’s comments and complaints were responded to appropriately.