Archived: SPN Healthcare

Updated 1 March 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 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.

The office visits took place on 17 and 27 January 2017. Both inspection visits were announced to ensure the provider and staff had sufficient time to meet with us. The first visit was conducted by one inspector. After our first visit we had concerns about the safety, health and well-being of people who used the service. We contacted the provider on 18 January 2017 and informed them of our concerns, and asked for an action plan to be sent to us within 48 hours outlining the action they would take to ensure people’s safety. We shared these concerns with commissioners of the service.

On 27 January 2017, two inspectors went back to the service to ensure actions the provider assured us they would take after our first visit, were in place. This second visit was also announced.

Before we visited SPN Healthcare we reviewed the information we held about the service, for example, the Statement of Purpose for the service.

We also conducted telephone interviews with two people who used the service and four relatives of people to obtain their views of the service they received.

During our inspection we spoke with the provider, the newly appointed care manager, newly appointed care coordinator and we conducted telephone interviews with nine care workers.

We reviewed five people's care records to see how their care and support was planned and delivered. We checked 12 staff files to see whether staff had been recruited safely and were trained to deliver the care and support people required. We also looked at other records related to people's care and how the service operated; including checks management took to be assured that people received a good quality service.

Updated 1 March 2017

SPN Healthcare is a domiciliary care agency which is registered to provide personal care support to people in their own homes. At the time of our visit the agency supported 11 people with their personal care. Many of the people being supported had a progressive illness where the focus was on palliative and end of life care. The service employed 15 care workers.

We visited the offices of SPN Healthcare on 17 and 27 January 2017. Both inspection visits were announced and we gave the provider 48 hours’ notice. This was to ensure we could meet with the provider of the service and staff on the day of our first visit. Our second visit was announced to ensure the provider was available to discuss the action they told us they would take after our first visit.

This was the first inspection of SPN Healthcare since they registered with us in April 2016. The provider told us that they had been providing a service to people since September 2016.

The service had a registered manager. A requirement of the provider’s registration is that they have 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. The provider is the registered manager for this service and will be referred to as ‘the provider’ throughout this report.

Some staff had not been recruited safely because the provider had not requested all the required pre-employment checks prior to staff starting work. This meant people were at risk of being supported by staff who were unsuitable to work with people who used the service.

Not all care workers had received an induction and the training required to meet people’s needs safely and effectively. Care workers practice was not being checked to make sure they worked in line with the provider’s policies and procedures. Furthermore, policies and procedures were not fully reflective of the service being provided and some were out of date.

The provider had not established effective procedures to check and monitor the quality and safety of the service people received. This meant the provider was not aware of potential poor practice and areas where improvement was necessary.

People’s care records provided staff with information about how people should be cared for. Staff spoken with had a good understanding of the needs and preferences of the people they supported.

Systems to ensure medicines were managed safely were not effective. People saw health professionals when needed. Support was given to people who required help with eating and drinking.

There were enough care workers to provide care at the agreed times. People received their care and support from care workers who they knew and people and relatives were involved in planning their care.

People and relatives told us they felt safe using the service and care workers understood how to protect people from abuse. Some risks associated with the delivery of care and support for people who used the service had been assessed. However, some risk management plans lacked detail and most risk assessments had not been reviewed.

The provider had some understanding of their responsibilities to comply with the relevant requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People’s capacity to make decision had been assessed. However, where people had been assessed as having capacity, assessments lacked detail about which decision was being considered. Care workers respected people’s decisions and gained people’s consent before they provided personal care. People told us care workers were kind and caring.

People’s privacy and dignity was respected by care workers. Where possible, care workers encouraged people to be independent. People told us care workers had a respectful and caring attitude and in their opinion had the right skills and experience to provide the care and support required.

People and relatives told us they knew how to raise any concerns and felt these would be listened and responded to effectively. Staff told us the management team were supportive.

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