Archived: Waveney Office

Our previous inspection in June 2017 had identified two breaches of Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because care plans were not person centred and did not contain sufficient information to ensure care was delivered safely. At this inspection we found that improvements had been made and the service was no longer in breach of the regulations.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of Safe, Responsive and Well-led to at least achieve a rating of good. This was provided and has been completed by the service.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. CQC inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. We also take into account any wider social care provided. At the time of our inspection the service was supporting 16 people.

Since our last inspection the provider had re-written all the care plans for people using the service. This had been carried out with the involvement of people using the service and their relatives. Care plans were now person centred and provided staff with the information they required to provide care and support required. Care records showed that people's needs were assessed before they started using the service.

People told us they felt safe whilst receiving care and support. The registered manager and care staff understood their responsibilities with regard to safeguarding people. Staff had received training in the protection of vulnerable adults.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There was an effective recruitment and selection procedure in place. Staff attend care visits on time and stayed for the agreed length of time. If a member of care staff was delayed due to unforeseen circumstances people were contacted to inform them of the delay.

There was a safe system in place for the management of medicines and medicines administration records were completed accurately.

Staff told us they were supported by the provider and registered manager and were comfortable raising any concerns. People and family members told us the management and office staff were approachable and if they had any concerns the would feel confident to raise them with the registered manager.

There were processes and procedures in place to identify any shortfalls in the service provided and ensure that people received a good quality of care. The provider had recognised where improvements were needed and taken actions to address these.

The service did not have a registered manager. The previous registered manager had left the service. The provider had recruited a manager. This person had not yet applied to register but was in the process of obtaining legal checks before they put in a formal application to the Care Quality Commission. 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.

Care plans did not contain sufficient information to enable care to be delivered effectively. There was little detail as to people’s likes, dislikes and preferences. Neither was there sufficient detail in the care plans to support staff to provide consistent care and support to people. In some cases, care plans did not contain information to ensure care staff met people’s individual needs. Care staff’s individual knowledge of people was relied upon for this information.

Care plans did not contain risk assessments to ensure that the care and support people received was carried out as safely as possible. There were no risk assessments in place for people’s moving and handling needs. You can see what action we told the provider to take at the back of the full version of the report.

Staff received training to support people with their medicines. However, the service did not follow its own policy with regard to carrying out a full assessment before supporting people with their medicines.

There were systems in place to protect people from abuse. Staff could identify the different types of abuse and knew what actions to take to report abuse. The service had made appropriate safeguarding referrals.

Staff had a good understanding of the Mental Capacity Act 2005. The service had worked with the local authority to obtain a Court of Protection Order where this was necessary for one person. Staff gained people’s consent and offered them choice when providing care and support.

People receiving support and care staff were complimentary about the management of the service.