Archived: Carevisions@Home Ltd

Updated 15 December 2018

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 between 25 October and 1 November 2018. We gave the service 48 hours’ notice of the inspection visit to ensure there would be somebody available in the office.

We visited the office location on 25 October 2018 and reviewed records, policies and procedures and spoke with the registered manger and office staff. Telephone calls were later made to people using the service and care staff and emails were sent to family members and external professionals.

The inspection team consisted of one inspector.

We reviewed information we held about the service, including the notifications we had received from the registered provider. Notifications are reports about changes, events or incidents the provider is legally obliged to send us within required timescales.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We also contacted the local authorities who commissioned the service and Healthwatch to gain their views of the service provided. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the feedback received to inform the planning of the inspection.

During the inspection we looked at four people’s care plans and medicine administration records (MARs). We looked at three staff files, including recruitment records. We spoke with eight members of staff, including the registered manager, head of operations, office and care staff. A further four staff provided feedback by completing questionnaires. We spoke on the telephone with two people who used the service and two relatives. We also received feedback from two health care professionals.

Updated 15 December 2018

This inspection took place between 25 October and 1 November 2018. This was an announced inspection to ensure there would be somebody available in the office and so that people could be informed that we wished to contact them for their views.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to a wide range of individuals including older people, younger adults and children.

Not everyone using Carevisions@Home Ltd receives regulated activity; Care Quality Commission (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. At the time of this inspection 13 people were receiving support which included personal care.

We previously inspected the service in March 2016 and rated the service as good overall. At this inspection we found the service was no longer meeting all the required standards to retain this rating.

This is the first time the service has been rated Requires Improvement.

We visited the office location on 25 October 2018 to see the manager and office staff and to review care records and policies and procedures. After our visit to the office we made calls to people who used the service and their relatives. We also requested information from the local authority and asked external health professionals for their feedback.

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.

The provider had recognised there were problems with the current delivery of care so, prior to our inspection had reduced the number of people being in an attempt to improve care delivery. However, people were still not always receiving support in a way they were happy with. People told us there were times when staff were not available to attend calls and call times could not always be changed to accommodate a change in circumstances. People and relatives told us they were not always supported by a regular team of staff and that communication with the office could be improved.

Medicine records did not contain all of the necessary information to guide staff on how to administer them correctly and safely. People were not always happy with the way their medicines were managed. Medicines audits were undertaken but had not picked up the issues we identified.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, decision specific capacity assessments were not always being undertaken.

Staff training was up to date and specialist training was delivered to meet the needs of the people being supported. Staff were happy with the training they received. Some people and relatives gave negative feedback about staff knowledge and we fed this back to the registered manager who planned to address this.

People were involved in their care planning and reviews. Care plans did not always include information about a person’s likes and dislikes. Some care plans included more detailed guidance to staff than others. Information was not readily available in an accessible format for people with a sensory impairment or learning disability. We have made a recommendation about this.

Audits and checks were conducted on a regular basis however they had not picked up on all of the issues we found.

The provider had systems in place to safeguard people from abuse. Staff completed safeguarding training and knew how to report any concerns.

People had individual risk assessments within their support files. Accidents and incidents were recorded and reviewed by the registered manager to minimise future risk. A plan was also in place to ensure the continued delivery of care in emergency situations.

Safe recruitment practices were undertaken to reduce the risk of unsuitable people being employed.

People’s care needs were assessed to ensure staff, medicines and necessary equipment were available to meet their needs.

Staff felt well supported by management. Regular supervision sessions took place along with annual appraisals.

People’s health and wellbeing was supported. People were supported to attend medical appointments where required.

Staff were passionate about their work and promoted dignity and independence. People who used the service and their relatives were all very happy with the approach of care staff.

Complaints were handled in line with the provider’s policy. Staff knew how to support people should they wish to make a complaint.

Quality assurance surveys were conducted and action plans were drawn up in response to feedback.

Staff meetings did not take place often but staff told us they felt supported by an approachable registered manager who would listen to and act on any points that were raised.