Background to this inspection
Updated
13 October 2017
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.
This inspection took place on 14 and 15 August 2017 and was announced. One adult social care inspector visited the office base on 14 August 2017 and an expert by experience who contacted people on 15 August 2017, to seek their views. Prior to the inspection we reviewed information from notifications sent to us by the provider and we contacted the local authority contracts and safeguarding teams.
We contacted one person who used the service and four relatives of people using the service.
We spoke with the registered manager and the client manager in person, along with a temporary client manager and five members of care staff over the telephone. We also reviewed people’s care records and documentation to show how the service was run.
Updated
13 October 2017
The inspection took place on 14 and 15 August 2017 and was announced. This was the first rated inspection of the location since its registration at this address in September 2016.
Interserve Healthcare is registered to provide personal care to people in their own homes. People supported by the service had very complex health needs. There were 18 people supported by the service at the time of the inspection.
There was a newly registered manager in post at the time of the 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.
People felt safe and staff explained their understanding of safe practice. Procedures for safeguarding people were in place and known by staff.
The overview of accidents and incidents was not robust and the review of people’s daily notes and medicine records lacked rigour.
Recruitment procedures were followed to ensure staff were vetted and their suitability to work with vulnerable people was checked. There was a recruitment programme in place although staff turnover was high and there were weaknesses in contingencies for staff absence. We have recommended the provider reviews this.
Staff had opportunities to update their skills and professional development, although systems did not enable managers to identify where the training needs were for the service as a whole. Competency checks for care staff were evident, but there was limited evidence of checks made to ensure the competency of registered nurses.
Staff demonstrated an understanding of the impact of the Mental Capacity Act (MCA) 2005 and had due regard for people’s rights. 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. However, care records did not always make clear where consent for care had been sought.
Staff had a caring attitude towards the people they supported and feedback we received about the service indicated the service was caring.
Care records illustrated people’s individualised care and support and were based on detailed pre-admission information. Daily notes about individuals’ care were maintained but not promptly brought into the office for the management team to review.
People felt supported to complain if they were unhappy about any aspect of their care and there was plenty of information for people to understand.
There were developing systems for auditing the quality of the provision and the newly registered manager had identified the strengths of the service and areas to improve.
You can see what action we have told the provider to take at the back of the report.