Archived: Pro Support Re-enablement Care Agency Limited

Pro Support Re-enablement Care Agency Limited provides care at home to people. They provide the regulated service of personal care to older people some of whom are living with dementia and may have physical disabilities or sensory impairment. At the time of our inspection 9 people were receiving a service from the agency.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People had person centred care plans that outlined how they wanted their care to be provided. Information in the plans was mainly good and detailed for staff guidance. The registered manager also risk assessed to mitigate the risk of harm to people. However, on some occasions information was incorrect or omitted and this meant staff might not have all the information they require to offer a good service to the person. This had not been identified and addressed during care record audits.

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

The registered manager and care workers supported people to access appropriate health and social care for their well-being.

People and relatives spoke positively about the care workers. They described them as caring and told us they usually arrived on time and communicated well with people. Relatives were pleased they had a consistent staff team and felt this was a strength the service provided.

The provider followed a safe recruitment process and training and support was provided to staff to help them to undertake their role. The registered manager undertook spot checks to ensure staff maintained good practice and spoke with people and relatives to get their feedback. People, relatives and staff found the registered manager approachable and responsive when they raised concerns.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published on 24 September 2019). At that inspection we found three breaches of the regulations in person centred care, safe care and treatment and good governance.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection not enough improvement had been made. The provider was still in breach of the regulations regarding person centred care and good governance. This was because omissions and misinformation in care plans had not been identified and addressed through the audit processes.

Why we inspected

This was a planned inspection based on the previous rating

We found no evidence during this inspection that people were at risk of harm

Please see the sections of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service is a domiciliary care agency and is registered to provide personal care to people living in their own houses and flats in the community. It provides a service to older adults some of whom could be living with dementia and to people with physical disabilities, sensory impairment and people who have an eating disorder.

Not everyone using Pro Support Re-enablement Care Agency Limited receives a regulated activity. CQC only inspects the service being received by people provided with ‘personal care’ and help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection the provider offered a service to five people four of whom received a service of personal care.

This was the service’s first inspection following their registration with the Care Quality Commission in June 2017. There was 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.

The provider was not always assessing risks to people in a robust manner and measures for staff to follow to minimise the identified risks were not always in place.

Care staff had received training to administer medicines in a safe manner and had signed to state they had administered medicines. However, instructions for care staff was not consistently written on each month’s medicines records and people’s care plans did not contained information to describe their medicines and when they should be taken. As a result there were risks that people might not receive their medicines as prescribed.

Care plans were not signed by people to show they had agreed to them and there were no consent forms in people’s records. Therefore, there was no evidence that people had agreed to the way their care was being delivered. We have made a recommendation to the provider to address this shortfall.

Care plans did not contain sufficient information about how people wanted to be cared for to be person-centred. They lacked information about the person’s background, interests and diversity support needs and guidance for staff was not detailed.

Although the registered manager had systems in place to audit and monitor records they had not identified the inconsistencies and omissions we found during our inspection.

People and relatives spoke positively about Pro Support Re-enablement Care Agency Limited and they described care staff as friendly, kind and professional. They all said they had not had any missed calls but all found care staff were not always punctual. Care staff described how they built a good working relationship with people, explaining they were introduced prior to the service starting and treated people in a respectful manner.

Staff recruitment procedures were adhered to for the safe recruitment of staff and the registered manager had ensured there were enough care staff to meet people’s needs. Care staff told us the registered manager and office staff were supportive and had provided induction training so they had the knowledge they needed to work with people in a safe way.

Care staff told us how they would recognise and report possible abuse and the registered manager had systems in place to report and investigate any safeguarding adult concerns. The registered manager described how they learnt from mistakes to avoid a reoccurrence and to develop the agencies systems and procedures.

Care staff demonstrated they supported people to access the appropriate health care and promoted healthy eating.

The registered manager visited people prior to commencing a service to assess their care needs and discuss how people wanted their care and support to take place. They monitored the quality of the service provided to people by undertaking spot checks and surveys. People and relatives said they found the registered manager approachable and could raise any concerns or complaints.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to person-centred care, safe care and treatment and good governance. You can see what action we told the provider to take at the back of the full version of the report.