9 December 2016
During a routine inspection
The service is a domiciliary care agency that provides personal care and support to people in their own homes. At the time of our inspection 119 people used the service.
The month prior to our inspection Fosse Healthcare had secured a large contract to provide care packages to people who had previously received their care from other providers. This meant that they were providing over double the care calls in the second week of November than they had the previous week. As part of this process Fosse Healthcare had transferred a number of staff from other providers to be employed by them. We had received feedback from people using the service, their relatives and the local authority that there were concerns about the quality of the care provided and significant disruption to people’s care packages. While the provider had clearly made some progress, at the time of the inspection a number of concerns remained.
The service had a 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 feel safe because they could not be sure that staff would arrive to provide their care. People could not be sure that they would receive their medicines as required. Staff were not given clear guidance and support in order to ensure that people were supported to take their medicines.
Staff had received training to keep people safe and understood how to raise concerns. Where issues relating to people’s safety had been identified they had not always been recognised and reported as safeguarding concerns.
Safe recruitment checks had taken place prior to staff employment. Staff understood their role in keeping people safe. Assessments regarding risks to people were not always completed, as a result people were not protected from the risk of avoidable harm.
Staff had received training and supervision to meet the needs of the people who used the service. Staff told us that they felt supported.
People were not supported in line with the requirements of the Mental Capacity Act 2005 (MCA)
People were supported to maintain their health. Staff provided people with food and drink to meet their nutritional and hydration needs.
People’s independence was promoted and people were encouraged to make choices. Staff treated people with kindness and compassion. Dignity and respect for people was promoted.
People’s needs for care had not always been assessed. Staff were not provided with a sufficiently clear understanding of how to support people who used the service. People did not always receive their care at the times that they needed or preferred.
People did not feel that they were listened to or that they could make contact with the service in order to request changes. Complaints were not managed in line with the provider’s complaints procedure.
Systems where not effective to review the care that people received and to check that these were in line with their assessed needs. Checks on the quality of the service that people received were in place but these were not robust.
The provider did not have an effective system for monitoring call times and ensuring that people received the care that they needed to remain safe. Audits had not been effective in identifying concerns and it was not clear what action had been taken to prevent re-occurrence.