Archived: Fortis House

Updated 14 January 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

Before the inspection we checked the information we held about the service. This included any notifications and safeguarding alerts. We also contacted the local borough contracts and commissioning teams that had placements at the service and the local borough safeguarding team.

During our inspection we went to the provider’s office. The inspection team consisted of two inspectors. We spoke with the registered manager, the operations director, the recruitment manager, and one administration assistant. After the inspection we spoke to three people who used the service, three relatives, four care workers and one field team leader. We looked at five care files, daily records of care provided, complaint records, four staff recruitment files including supervision and training records, minutes for various meetings, medicine records, and policies and procedures for the service.

Updated 14 January 2017

We inspected Efficiency-For Care Limited on 28 September & 6 October 2016. This was an announced inspection. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. This was the first inspection of the service since it was registered with the Care Quality Commission. The service was providing support with personal care to 20 adults living in their own homes at the time of our inspection.

There was a registered manager at the service 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 and associated Regulations about how the service is run.

There were some arrangements to manage medicines safely and appropriately. Records showed care workers had received medicines training and medicines policies and procedures were in place. However, we found the service was not completing Medication Administration Records (MARs) when administering medicines to people effectively. People were therefore at risk of not receiving their medicines safely.

Recruitment and selection procedures were not always safe. Staff records showed interview records were not fully completed for some staff members. Recruitment and selection procedures were not always carried out in line with the provider’s policy and procedure and may place people using the service at risk of harm by unsafe recruitment and selection practices. The provider’s induction policy stated staff should have their induction checklist completed and signed off during the three month probationary period of employment and that staff should be monitored through regular supervision. Staff files did not show that this was taking place.

Staff understood their responsibility to provide care in the way people wished and worked well as a team. They were encouraged to maintain and develop their skills through relevant training. There were sufficient staff deployed to provide care and staff were supported in their roles with training and supervision. However two staff had not received formal supervision.

The service did not have effective quality assurance and monitoring systems in place. Records were not always complete and up to date.

Staff had undertaken training about safeguarding adults and had a good understanding of their responsibilities with regard to this. Updated risk assessments were in place which provided information about how to support people in a safe manner. Staff understood their responsibilities under the Mental Capacity Act 2005.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people and their relatives were involved in making decisions about their care.

Staff told us they felt supported by the registered manager and the senior management team. Staff, people who used the service and relatives felt able to speak with the senior management team.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of this report.