12 September 2018
During a routine inspection
There was a registered manager in post at the time of our inspection. 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 the time of the inspection, 33 people received some element of support with their personal care. This is the service’s second inspection under its current registration. At the previous inspection, the service was rated as ‘Requires Improvement’ overall. At this inspection, they have remained at this rating and we identified one continued breach of the Health and Social Care Act 2008 (Regulated Activities).
You can see what action we have told the provider to take at the end of this report.
The risks to people’s health and safety had been assessed but the recorded assessments were not personalised and did not always reflect people’s individual care needs. Most people were satisfied with the punctuality of the staff, however records showed there were times when calls were regularly late. There had been a high turnover of staff however this had now stabilised and staff retention had improved. Staff were recruited safely and people were supported appropriately with their medicines. Staff were aware of how to reduce the spread of inspection. The registered manager investigated accidents and incidents; however, their decisions were not analysed and reviewed by the provider.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; however, the policies and systems in the service did not always support this practice. People had care records in place. These were not always developed in line with current legislation and best practice guidelines. Staff received an induction and training programme, however some staff required refresher training which had not yet been arranged. People felt staff understood how to support them in their preferred way. Where needed, people were supported with their meals, however nutritional assessments were generic and not personalised to people’s needs. Other health and social care agencies were involved where further support was needed for people.
People felt staff were kind and caring, treated them with respect and ensured their dignity was maintained. People liked the staff and their independence was encouraged. People were involved with decisions about their care. People’s personal data was protected in line with the current legislation.
People’s needs were assessed prior to commencing with the service. This enabled staff to have the information needed to support them effectively. People’s records were person centred and informed staff how to support people in their preferred way. People felt staff responded to their complaints effectively, records viewed confirmed this. People’s diverse needs were discussed with them during their initial assessment. End of life care was not currently provided by the service.
Some improvements had been made to the quality assurance processes since our last inspection. However, they were still not fully effective in identifying areas of risk within the service. The registered manager received limited input from the provider to ensure they were held accountable for their decisions and the effectiveness of how the service was managed. The registered manager now had administrative staff in place, which meant they could delegate some responsibilities and focus on managing the service. The registered manager carried out their role in line with their registration with the CQC. Notifiable incidents were reported to the CQC.