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Archived: SPN Healthcare Requires improvement


Inspection carried out on 17 January 2017

During a routine inspection

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 Furthermore, policies and procedures were not fully reflective of the service being provided and some were out of date.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