Background to this inspection
Updated
5 August 2016
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 inspection took place on 28 June and 1 July 2016 and was announced. The provider was given 48 hours’ notice because the location was a domiciliary care agency and we needed to be sure that someone would be present in the office.
The inspection was made up of one inspector for adult social care.
Prior to the inspection we reviewed the records held on the service. This included previous inspection reports and notifications. Notifications are specific events registered people have to tell us about by law.
During the inspection we spoke with the two managers who were responsible for the day to day running of the service and five members of staff. We also visited three people in their own home and spoke with one relative. We looked at five records related to people’s individual care needs. These included support plans, risk assessments and daily monitoring records. We also looked at five staff recruitment files and records associated with the management of the service, including quality audits.
Following the inspection we sought the views of a number of professionals who know the service well; a community psychiatric nurse, a health care assistant and two community nurses.
Updated
5 August 2016
The inspection took place on 28 June and 1 July 2016 and was announced. The provider was given 48 hours’ notice because the location was a domiciliary care agency and we needed to be sure that someone would be present in the office.
Morwenner Care provides a personal care service to people living in their own home. On the day of the inspection 26 people were supported by Morwenner Care with their personal care needs.
The service had a registered manager in post. 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.
There were two managers in post who were responsible for the day to day running of the service and were supported by the registered manager. The registered manager was not available at the time of the inspection.
People had not had their medicines managed safely. Medicines administration records were all in place, but had not all been correctly completed. Staff had received medicine training but there were no systems in place to assess staff’s ongoing competency to administer medicines.
People’s risk assessments did not record all factors that affected risks for people, such as their weight or communication needs. They did not identify all steps staff needed to take to help ensure people were safe. Incident forms had not been completed to inform managers and put in steps to help ensure similar incidents were avoided in the future. Incident forms had not always been completed to help ensure risks were mitigated in the future.
The managers and staff had not attended training on the Mental Capacity Act 2005. People had not received mental capacity assessments as required and staff had not been given guidance about how people’s mental capacity might influence the way they received care and support.
People’s support plans did not always contain details of significant health or social care needs and how staff needed to support these; nor did they record information about people’s every day preferences and routines.
The managers had not informed CQC of significant events in line with legislation.
Audits had not been carried out on records to help highlight and act on any gaps in recording. This meant the managers had failed to identify the concerns we found during the inspection.
Staff described what actions they took on a daily basis to help keep people safe and were confident recognising and reporting signs of suspected abuse. The provider had recruitment and selection processes in place and carried out checks when they employed staff to help ensure they were safe.
New staff undertook training relevant to their role and shadowed experienced staff members prior to working alone. Training needed updating for most staff and the managers were in the process of planning this.
People described the staff as caring and valued the interaction they had with them. Staff and the managers were keen to provide a good quality service to people and were responsive to requests made of them.
People and staff were complimentary about the management. Staff were supported by formal one to one and team meetings and were confident when raising any concerns or asking for advice.
We found breaches of the regulations. You can find details of our full concerns at the back of the report.