18 May 2017
During a routine inspection
Stirling Home care provides personal care and support for people living in their own homes. At the time of our inspection there were 27 people using the service.
This was the first inspection of this location since it was registered in June 2016.
There was no registered manager in post at the time of our inspection. 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 was in breach of their conditions of registration, because the registered manager left some time ago and the provider had failed to inform us of the changes and no new application to register a manager had been received
The service was not well led because of the lack of an effective management structure and a lack of systems in place to monitor the quality of the service. The provider was not fulfilling their responsibilities to inform us (Care Quality Commission) of incidents they were required to keep us informed about. The provider was failing to listen and respond to the views expressed by people and staff to ensure that improvements could be made where appropriate. There were no processes in place to monitor the quality of the service that people received.
People did not receive a safe service. This was because where issues regarding people’s safety had happened the provider did not take the appropriate actions to ensure that people were safeguarded. The provider had not ensured that staff had the training and skills to ensure people were protected from unsafe care and treatment and their rights protected. Adequate risk assessments were not in place to ensure staff were aware of how to support people safely and in a consistent manner.
The provider had not followed safe recruitment procedures to ensure that only suitable staff were employed to support people. The lack of safe recruitment practice had the potential to put people at significant risks.
The provider could not be assured that people received their prescribed medicines safely as required. This was because the procedures for supporting people with taking their medicines were not safe.
Safe procedures were not in place to assess and manage risks to people’s care. People’s needs were not fully assessed and planned to ensure their specific and changing needs were adequately recorded so that staff would always have the information they need to support people. This could potentially put people at risk of receiving unsafe care.
Staff were not appropriately trained, supported and supervised to ensure people received an effective service that respected people’s rights.
People were supported to maintain their diet and health needs where required. Staff were caring and people’s privacy, dignity and independence was respected and promoted by staff. However, this was as a result of the efforts of care staff, rather than guidance from the provider to ensure people received a caring service at all times.
You can see what action we told the provider to take at the back of the full version of the report.
The overall rating for this service is ‘Inadequate’ and the service is therefore in special measures.
Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.
The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.
If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.
For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.”