Archived: Rowen Homecare Support Services

Is the service safe

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

Is the service safe?

We previously inspected this service in April 2014 and found that they were not meeting Regulations 10, 20 and 21. We carried out a follow up inspection over two days on 17 June and 3 July 2014 where we found that the provider was not meeting the requirements of Regulations 10,20 and 21. We have taken action against this provider.

Staff personnel records did not contain all the information required by the Health and Social Care Act 2008. This meant that the provider could not demonstrate that the staff employed to work for this service were suitable and had the skills and experience needed to support people in their own homes.

The provider had not made sure that the risk to people's health and welfare was assessed, monitored and managed appropriately. Safeguarding procedures were not robust and staff were not clear about how to safeguard the people they supported.

Is the service effective?

People's health and care needs were assessed with them but they were not involved in writing their plans of care. We did not see evidence of people been involved in reviewing their care plans.

Staff did not always have the appropriate training needed to meet peoples needs.

Is the service caring?

People told us that they were happy with the care they received. One person told us, "We are very happy with them".

We saw that some of the carers we spoke with had a caring attitude towards the people for whom they provided care.

Is the service responsive?

We did not find this service responsive because people were not supported to express their views; they were not involved in writing their care plans or reviewing their care.

Staff did not respond to concerns raised appropriately. They did not explore them fully and did not report or record incidents.

Is the service well led?

We did not find that this service was well led. We did not see good leadership from the provider and there were inconsistencies between what the provider said and what the staff told us.

There was no robust quality management system in place.

There were not clear processes in place so that staff knew what was expected of them in terms of values and behaviours and what process would be followed if these were not adhered to.

The provider did not follow up serious concerns that had been raised.

Is the service caring?

Is the service responsive?

Is the service safe?

Is the service effective?

Is the service well led?

This is a summary of what we found-

Is the service safe?

We spoke with people who used the service who told us they feel safer because carers from this service support them. One person said, " I know my mum is well cared for and I feel better knowing that the carers are there".

We saw that there were areas of strength within this service. The care staff knew the people they cared for well and the people who used the service were satisfied with the care they received.

However, when we looked at the policies and procedures relating to Rowen Homecare Support Services we found that they were out of date. When there had been a recent safeguarding concern the service had not followed the correct procedures. There was an effective system for recording accidents and incidents but there were no tools in place for the staff to manage that information and learn from it.

The service had not taken account of the Mental Capacity Act 2005 and its main Codes of Practice. Staff had not had training in this area and did not have a good working knowledge of the Act. The service had not recorded any decision making protocols for those people who were not able to make their own decisions. There was no record of any best interest decision making by the service.The service had not completed comprehensive risk assessments for the environment or peoples physical and mental health.

People did receive their medication as prescribed. People who used the service could administer their own medication safely with minimal support from staff.

The service did not follow safe recruitment practices. Staff were allowed to work in people's homes without having had the necessary checks carried out.

Is the service effective?

One person told us that before their relative started to use this service the manager carried out a "thorough assessment" and that they were involved in the assessment. Another person told us that, "Someone came from Rowen Care to talk to us and assess our needs". We saw from care files that there had been an assessment carried out and that those needs were recorded clearly for staff to read.

People who used the service told us that they felt confident with the staff that came to their home. One person's husband told us, "The staff are very concerned and do their best to make her comfortable". One person said that staff chatted with them and they enjoyed staff coming.

Staff had had some form of induction when they began working at the service. They had completed mandatory training so that they could work safely with people.

Is the service Caring?

One person told us,"We had never dealt with an agency before and I was very worried at first but now that I have got to know the carers I find their attitude and caring is very good. I don't think they could improve". Another person told us,"They're very helpful.They treat me with respect". One person whose relative received a service from Rowen Homecare Support Services said," They are always treated with dignity and respect".

It was clear when we interviewed staff that they knew the people they supported well and showed concern for them. When there were any changes in a person's needs the staff informed the manager who made changes to the care plan. They told us that they would visit the person to go through the care plan with them.

Is the service responsive?

When we inspected care files we saw that an assessment had been carried out and that there was a care plan in place for each person. When writing the care plan staff had not taken account of the Mental Capacity Act for deciding if a person had capacity or needed some support to make decisions.

No complaints had been made to the service since the last inspection but each person had been provided with a complaints, concerns and compliments form which they or their relatives could complete if they wished. This form was kept in their care file at the person's home.

Is the service well-led?

This service is a small service where the manager is also the sole director of the service. There had been some concerns raised with Care Quality Commission (CQC) about the service by the local authority because the manager had allowed people to start work without the correct checks being carried out to ensure that people were safe.

We could see that the manager was a very caring person but they did not have the administrative skills to ensure that the office was managed effectively. They were carrying out a variety of roles themselves in addition to the management of the service. This meant that there was some disorganisation in administration with records not kept up to date. The manager herself said that she was " not good with figures and found the administration difficult".

We saw that there was no effective or robust quality assurance system in place which meant that the service was not learning from any audits and that there was no continuous improvements at the service.

The manager did recognise their own strengths and areas of weakness and was proposing to employ a deputy manager to help run the office. They had already employed a book keeper for invoicing.

The manager has agreed voluntarily not to accept any new contracts until this situation is resolved.

Medication was handled safely, and staff were recruited appropriately so that people were protected.

The service had a complaints policy and procedure and people told us that any concerns they had were listened to and acted upon.