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Community Care Worker Limited Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 December 2018

We carried out an announced inspection at Community Care Worker on the 28 September, 1 October 2018 and 3 October 2018. At the last inspection on the 9 August 2017, we found breaches in regulations. Regulation 13 because people were not always safeguarded from potential abuse and Regulation 19 because the provider did not have effective systems in place to ensure staff were safely recruited. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question of safe to at least good. We served a warning notice under Regulation 19 which asked the provider to take immediate action to make improvements. We found improvements had been made to Regulation 13. However, we found there was a continued breach in Regulation 19 and the provider needed to make improvements to the way the service was managed. This is the fourth consecutive time the service has been rated Requires Improvement.

This service is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to older adults and younger adults who have a physical or learning disability. At the time of the inspection there were 20 people receiving a service of personal care within their own homes.

Not everyone using Community Care Worker receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager at the service who is also the provider. 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.

There was a lack of structure and organisation within the service, which impacted on the monitoring of some people’s care and led to breaches in regulations. Improvements at the service had not been acted on in a timely manner to ensure regulations were met and lessons had not been learnt when things went wrong.

Staff felt the registered manager was not always approachable and did not always listen to them when they raised concerns.

Records were not stored securely and improvements were needed to ensure records were accurate and accessible in the absence of the registered person.

The provider was not meeting the conditions of their registration because they were storing documents at an unregistered address.

The provider had not made the necessary improvements since the last inspection to ensure staff were consistently recruited safely.

Improvements were needed to ensure actions in place as a result of complaints were recorded in care records for staff to follow.

Staff were aware of their responsibilities to protect people from the risk of harm. Staff knew people’s risks and supported them to remain as independent as possible whilst protecting their safety.

There were enough staff available to meet people’s needs in a timely way. Medicines were managed safely and infection control measures were in place to protect people from the potential risk of cross infection.

People’s cultural and diverse needs were planned for to enable a fully individualised care provision that met people’s preferences.

The provider was following the principles of the Mental Capacity Act 2005. This meant that people were receiving care that was in their best interests. People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People’s care was reviewed. However, this information had not always been included in people’s records to ensure they received care that met their changing needs.

Staff received training to carry out their role effectively.

People were supported to eat and drink sufficient amounts and nutritional risks were assessed and monitored.

People’s health was monitored and health professionals input was sought where needed.

People were supported by kind and caring staff who ensured people’s dignity was maintained and their right to privacy was upheld.

People’s choices were promoted and respected by staff in a way that promoted people’s individual communication needs.

People received care from a consistent staff group which met their individual needs and preferences.

People and relatives felt able to approach the registered manager.

Feedback about the quality of care had been gained from people and checks on staff performance had been completed to ensure people were receiving the care required.

We found there was a breach in regulation 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 the report. 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.

Inspection areas

Safe

Requires improvement

Updated 11 December 2018

The service was not consistently safe.

Improvements were still needed to ensure the provider consistently followed safe recruitment procedures to protect people from the risk of receiving support from unsuitable staff.

People were supported by staff who knew how to manage and reduce risks to their health and wellbeing. However, there was a risk of inconsistent and unsafe support because sufficient guidance was not always available to staff.

Staff were aware of their responsibilities to protect people from the risk of harm. People received their medicines as prescribed. There were enough staff available to meet people’s needs and infection control measures were in place to protect people from potential infection risks.

Effective

Good

Updated 11 December 2018

The service was effective.

Staff had received an induction and training before providing support to enable them to carry out their role effectively. People’s diverse needs were assessed and planned to enable individualised support to be provided.

People’s consent was gained before staff provided support and the provider was following the principles of the Mental Capacity Act 2005. This meant that people received care that was in their best interests.

People were supported to eat and drink sufficient amounts to maintain their wellbeing. People’s health was monitored and health professionals input was sought and followed. A system had been implemented to pass information to staff to ensure people received consistent care.

Caring

Good

Updated 11 December 2018

The service was caring.

People were supported by caring and kind staff who respected their dignity and their right to privacy was upheld. People were supported to make choices in the way their care was provided and were supported in line with their individual communication needs.

Responsive

Requires improvement

Updated 11 December 2018

The service was not consistently responsive.

Improvements were needed to ensure the system in place to act and respond to complaints was effective.

People’s care was reviewed to ensure they received care that met their changing needs. However, improvements were needed to ensure that people’s records were updated with this new information.

People were supported in line with their preferences which were detailed in their care records.

Improvements had been made to the time allowed for staff to travel between visits, which ensured people received their support at a time they needed it.

Well-led

Requires improvement

Updated 11 December 2018

The service was not consistently well led.

There was a lack of structure and organisation within the service, which impacted on the monitoring of some people’s care. Improvements at the service had not been acted on in a timely manner to ensure regulations were met. Records were not stored securely and improvements were needed to ensure records were accurate and accessible in the absence of the registered person. Staff felt they were not always listened to when they raised concerns.

The provider had not acted in accordance with conditions of their registration.

The provider was displaying their current rating at the service and on their website and worked in partnership with external agencies.

Feedback had been gained from people and their relatives and checks on staff performance had been undertaken.