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Accommodating Care (Driffield) Requires improvement

We are carrying out a review of quality at Accommodating Care (Driffield). We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 5 April 2018

This was an announced inspection which took place on the 4th and 18th January 2018, and 15 February 2018. The inspection was announced to ensure that the registered manager would be available to assist with the inspection visit. At the last inspection, the service was rated good. At this inspection we found the service to be requires improvement in safe, effective, responsive and well-led.

Accommodating Care (Driffield) is a domiciliary care provider which supports people with personal care who live in their own homes in areas of the East Riding of Yorkshire. They support people with a range of needs, including people living with dementia. At the time of our inspection there were 48 people using the service.

Not everyone using Accommodating Care (Driffield) was receiving the regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager in post at the time of our inspection that had been running the service since August 2017. Following the inspection the local authority advised us that the registered manager had served their notice and was due to leave the provider within a couple of weeks. A registered manager is a person who has registered with CQC 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.

Staff were knowledgeable about maintaining people's safety and how to report any abuse or allegations of abuse should they need to. However, we did find that safeguarding information had not been recorded centrally and the provider lacked oversight in this area.

Staff training schedules were not in place to identify training that had been completed and highlight when refreshers were due. Some staff records showed very little training and the provider did not have this information. We could not be sure that staff had received the training necessary to carry out their roles effectively. This was an area the registered manager was reviewing in order to ensure all training was current for all staff.

Disciplinary procedures were in place and the provider had utilised these when necessary. However, when errors had been identified and the disciplinary process opened, staff had not been offered additional training to support them and observations to check competency had not been considered.

Accidents and incidents were recorded in people’s individual care files. However, these were not always fully completed and lacked details of actions taken and referrals made to other health professionals. There had been no overall analysis or review so that lessons could be learnt.

Recruitment processes were not robust. The registered manager had obtained only one reference for some employees, identification documents were not always present and some application forms contained conflicting information that differed from the curriculum vitae provided. We could not evidence that the registered manager had questioned these discrepancies at the interview stage.

Risk assessments did not always contain sufficient detail to guide staff in how to mitigate risks and some had not been reviewed since 2015.

The provider had failed to implement regular checks to identify medicine errors despite their being recent issues with medicines administration. Since our inspection the local authority were supporting the registered manager to improve in this area.

People told us they received consistent carers that attended within thirty minutes either side of the allocated timeframes. People told us that staff offered choices to them and supported their independence. People felt that staff respected their privacy and dignity at all times

Inspection areas

Safe

Requires improvement

Updated 5 April 2018

The service was not always safe.

Safeguarding incidents were not logged in a central place so that the provider could analyse them to ensure preventative measures were put in place and lessons learnt.

Accidents and incidents were recorded in people's files, no overall analysis had been completed and actions taken were not always recorded. Risk assessments did not always include details of preventative measures to mitigate risks so that staff had guidance to follow.

Medicines were not always safely managed and administered.

The provider supported people to be as independent as they could be and supported people's choices and preferences.

Effective

Requires improvement

Updated 5 April 2018

The service was not always effective.

We found not all records demonstrated staff had completed inductions, competency checks and basic training. No records were in place to identify training staff had completed and needed to refresh.

Supervisions and appraisals had not been completed in line with the providers policies and procedures.

Staff knew the importance of gaining people's consent and respecting their choices. Staff supported people to access services from other health professionals when needed.

Caring

Good

Updated 5 April 2018

The service was caring.

People told us that staff were kind and compassionate towards them. They were knowledgeable about their needs and supported them well.

Care plans detailed people's likes, dislikes and preferences and staff offered choices in line with the information recorded. Staff supported people to maintain relationships with their families and friends.

Staff supported people to be as independent as they could be by encouraging them to do things for themselves when they were able.

Responsive

Requires improvement

Updated 5 April 2018

The service was not always responsive.

Staff felt that additional training specific to people's needs would assist them to support people in a more person centred way.

People were involved in their care planning and reviews. However, these were not consistently and regularly reviewed so that they reflected people's current needs.

Complaints were investigated thoroughly and regular correspondence was sent to complainants outlining actions taken and what they could do if they were not satisfied with the outcomes.

Well-led

Requires improvement

Updated 5 April 2018

The service was not always well-led.

Senior management lacked oversight of the running and management of this service. Systems and processes were not in place to regularly analyse and monitor information to drive improvements.

Staff had not been given the training, skills and support to carry out their roles in an effective person centred way.

Safeguarding and accidents and incidents information had not always been fully documented, it was difficult to see whether appropriate actions had been taken and, where actions had been put in place, whether these had been carried out.