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Archived: SPN Healthcare Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

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 Furthermore, policies and procedures were not fully reflective of the service being provided and some were out of date.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 c

Inspection areas

Safe

Requires improvement

Updated 1 March 2017

The service was not consistently safe.

Some staff had not been safely recruited because checks to ensure their suitability to work with people who used the service were not carried out prior to them starting work. Systems to ensure the safe management of medicines were not effective. People told us they felt safe with care workers and there were enough care workers to provide the support people required. Some risk assessment lacked detail. However, care workers understood the risks relating to people’s care. Care workers knew how to safeguard people from harm and understood their responsibility to report any concerns.

Effective

Requires improvement

Updated 1 March 2017

The service was not consistently effective.

Some staff had not been inducted into the organisation or completed the training needed to ensure they had the knowledge and skills to deliver safe and effective care to people prior to working with people in their own homes. This was being addressed. The provider had a basic understanding of their responsibilities under the Mental capacity Act (2005). Staff obtained people’s consent before care and support was provided. Care workers supported people with their nutritional needs and to access health care when needed.

Caring

Good

Updated 1 March 2017

The service was caring.

People were supported by care workers who they considered caring and respectful. Care workers respected people’s privacy and dignity and encouraged people to maintain their independence. People were able to make everyday choices which were respected by staff.

Responsive

Good

Updated 1 March 2017

The service was responsive.

People were supported by care workers they knew and who understood their individual needs. Care calls were provided at the times people needed to support them effectively. People’s care plans informed care workers how people wanted their care and support to be provided. People and relatives were involved in planning care needs. However, care plans had not been reviewed. People and relatives knew how to make a complaint, and complaints were managed in line with the provider procedure.

Well-led

Requires improvement

Updated 1 March 2017

The service was not consistently well-led.

The provider had not ensured that effective quality assurance procedures were in place to assess and monitor the quality and safety of the service people received. This meant that areas of poor practice in relation to the service had not been identified. People and relatives spoke positively about the service provided and felt able to speak with the management team if they needed to. Care workers said the management team were approachable and supportive. The provider was the registered manager at this service.