Archived: Synergy Homecare - Leeds

At the last inspection on 27 June 2016, we asked the provider to take action to make improvements around consent, safety and governance and this action has been completed. However we had found further concerns around audits that had been completed.

Synergy Homecare - Leeds provides personal care and support to people who are elderly and may be living with dementia and are living in their own homes in Leeds and the surrounding areas.

The service did not have a registered manager in place. 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 service was caring. People received support from caring, committed and compassionate staff. A strong caring ethos was promoted by the registered manager and area manager, which ensured the staff team kept people at the heart of the service.

Staff sought ways to improve people's lives and people using the service said staff frequently went over and above to assist them and ensure they were happy and safe. People confirmed they were always treated with dignity and had their privacy respected.

There were sufficient numbers of staff employed to provide people with their planned service. People were supported by a stable, skilled and caring team, who knew each person well. People said they were safe using the service because it was reliable; staff were well trained and caring.

Staff were knowledgeable in relation to safeguarding people from abuse and they knew how to keep people safe from avoidable harm. Risks to individuals had been identified and there was guidance for staff on how to keep people safe. Where people were assisted with their medicines this was administered safely.

Accidents and incidents were recorded and analysed for trends and how to make improvements Staff told us how they were instructed to respond following an accident or incident.

The provider had systems for monitoring the quality of the service provided. We found audits identified areas of concern. The information gained fed into an action to solve concerns identified and reduce reoccurrence. However, recording documentation for medicines was not always completed correctly. This had been regularly identified in audits but this area of concern was not showing improvement.

There was an effective recruitment and selection process in place and the necessary relevant checks had been obtained before new staff started to work alone.

People's right to make decisions for themselves was respected and staff sought consent when delivering care and support. People were supported to ensure they had a sufficient amount of food and fluid to promote their wellbeing. People received support from staff who understood and responded to their health needs.

People's needs had been assessed before their support started. People and their relatives (where appropriate) confirmed they had been involved in creating and updating their care plans. Care records were personalised and reflected people’s current needs. All people felt involved in making decisions about the care and support they needed. One person described the relationship of care that had formed, ensuring they were fully involved in their care and support.

People said they knew how to contact the provider at any time, and felt confident about raising any concerns or other issues. Most people told us staff would deal with any concern raised.

The service is registered to provide personal care to people living in their own home. The service can provide care and support to people of any age.

The service did not have a registered manager at the time of our visit. A newly recruited manager was in post who had begun the process to register with the CQC. 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.

Systems for the management of medicines to make sure people received their medicines safely were not robust. Staff did not have all the guidance to enable them to know when to administer a person’s medicine. We saw gaps in records to confirm a person had received their medicine as prescribed.

Prior to providing a service, staff completed environmental risk assessments of the person’s home. Safety checks covered gas and electricity points, equipment to be used and general environment checking for clutter and falls risks.

There were risk assessments in place for people who used the service but we saw some areas of need were not risk assessed. We also saw staff had delivered support which had not been assessed and therefore the level of risk was not known.

Care records reviewed contained information about the person's likes, dislikes and personal choices. We saw people and their families were involved in developing their care plan with staff.

The manager and staff we spoke with had an understanding of the principles and responsibilities in accordance with the Mental Capacity Act (MCA) 2005. Staff could tell us how they were supporting people in line with the principles of the MCA. However there were no records of MCA assessments or best interest decisions where staff had highlighted a person may lack the capacity to make their own decisions.

There were systems in place to monitor and improve the quality of the service provided but they were not always effective. The registered provider had a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident staff would respond and take action to support them. However actions put in place to prevent a recurrence of an issue were not always completed.

Staff told us the manager was supportive. The manager had put in place a plan to ensure staff received regular supervision and an annual appraisal. The majority of staff were up to date with training. Staff told us they had received training which had provided them with the knowledge and skills to provide care and support. Outstanding training had been arranged for July at this location 2016.

There were enough staff employed to provide support and ensure people’s needs were met. However more staff were needed to relieve senior staff from caring duties and to provide consistent staff teams to people who used the service. Recruitment was on going. Effective recruitment and selection procedures were in place and we saw appropriate checks had been undertaken before staff began work.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of the different types of abuse and what would constitute poor practice. People and family members told us staff treated people with dignity and respect. People told us staff were caring.

People were provided with their choice of food and drinks which helped to ensure their nutritional needs were met. Staff at the service worked with other healthcare professionals to support people to maintain good health and wellbeing.

Breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were found during this inspection. You can see what action we told the provider to take at the end of this report.