Background to this inspection
Updated
22 April 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 7 and 8 March 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
The inspection team consisted of three inspectors and two experts by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection we reviewed safeguarding records and other information received about the service. We checked if notifications had been sent to us by the service. A notification is information about important events which the provider is required to tell us about by law. We spoke with the Local Authority safeguarding and commissioning teams. This inspection was brought forward as a result of receiving some concerning information about the service.
During the inspection we spoke with 22 people who used the service and seven relatives. We also spoke with 16 care staff, the deputy manager, the registered manager and managing director.
We reviewed a range of records about people’s care and how the service was managed. We looked at plans of care for 10 people which included specific records relating to people’s capacity, health, choices, medicines and risk assessments. We looked at daily reports of care, incident and safeguarding logs, compliments, complaints, service quality feedback forms, audits and minutes of meetings. We looked at the training plan for 52 staff members, recruitment records and training records for eight staff members and spot check and supervision records for 50 care staff.
We asked the provider to send us information after the visit. This information was received.
The provider had purchased the care company who were previously based in this location in April 2015. Staff and service users had transferred from the previous care company to the provider. This was the provider’s first inspection at the location.
Updated
22 April 2016
This inspection took place on 7 and 8 March 2016. The inspection was announced.
Community Angels Limited – Truecare Hampshire, provides personal care and live in services to people in their own homes. They provide services to older people, people living with dementia and people with complex health needs. At the time of our inspection there were 113 people receiving personal care from the service. There were 50 care staff and three co-ordinators who planned people’s care. There was a deputy manager, operations manager, one administrator, managing director and 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 did not always receive a visit and did not have confidence in the care staff who supported them. Staffing levels were insufficient to meet people’s needs particularly in the evenings and at the weekend. People felt their care calls were rushed.
Safe recruitment practices were not always followed. Medicines were not always managed safely. Effective systems to manage and monitor accidents and incidents were not in place.
Staff did not always have the skills, abilities and training to provide the support people needed. Staff had a limited understanding of the Mental Capacity Act 2005. Staff received supervision but did not always feel supported during the supervision. Team meetings did not take place. Staff received an induction programme.
People were not always supported correctly by staff when preparing meals.
Staff were not always kind, caring or compassionate when care was provided. Most people felt their privacy and dignity was respected and promoted.
People knew how to make a complaint. Complaints were received and investigated however there was no record of the outcome of the complaint.
Concerns had been raised to the manager and these concerns were still apparent during the inspection process. Records were not in place to demonstrate that these concerns had been identified and dealt with.
Auditing systems were not in place to assess the quality of the service and assess and mitigate the risk to people who used the service.
Staff felt supported and confirmed some improvements had been made but there were some concerns with the communication between the office and care staff.
Safeguarding concerns had been dealt with and the Commission had been notified. Staff demonstrated a good understanding of the whistleblowing process.
Some improvements had been made with the service but people were still experiencing problems with receiving their visits on time and the skills and knowledge of staff.
People were involved in their care and felt they made decisions about their care. Staff promoted people’s independence by encouraging and supporting them to complete some personal care tasks they were able to do.
People were supported to maintain good health and access on-going healthcare support and the service worked alongside health care professionals for people who had complex health needs.
Risk assessments were completed for people which identified risks to their environment and highlighted if manual handling equipment was required. Staff reported and acted appropriately when incidents occurred.
People’s needs were assessed and reviewed and people were involved in the assessment of their needs. Care plans were individual, personalised and contained detail specific to their individual needs.
We found a four 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.