5 December 2017
During a routine inspection
Personal care is a regulated activity; 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 who had been registered with the service since 25 November 2016. 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.
There were insufficient systems in place to assess and monitor and improve the service. Where the registered manager had identified issues with the quality of the service they had failed to implement changes. The service needed to improve their existing culture to embrace the changes required to ensure people are treated with respect and working practices were carried out in line with the protected characteristics under the Equality Act.
People did not always receive their medicines properly or safely as there were insufficient systems in place to monitor staff competency and records. People did not have the opportunity to have their medicines as prescribed as staff were not deployed at times when medicines were required.
People were not always adequately assessed for their risks or have plans of care to mitigate their known risks. There was no system in place to assess people using current standards or evidence based guidance.
People did not always have the opportunity to have all of their meals as their care calls were either spaced too far apart or too close to each other to have regular meals. People were not adequately monitored for their risks of poor nutrition and hydration.
People did not always receive their care at the times they preferred. Staff did not always arrive at the time specified on the rota or stay the whole allocated time.
There was no system in place to record all incoming calls to the office, which meant there was a risk that people’s verbal complaints or incidents would not be analysed or acted upon. Where people made written complaints there were systems in place to act on them. However, there were no systems in place to ensure people with a disability or sensory loss could access and understand information they were given. We made a recommendation that the provider explores how they will comply with the Accessible Information Standard.
People’s care was provided by staff that had received training and support to carry out their roles. Staff had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them.
Where people chose to stay at home as they approached the end of their life. Staff referred people to healthcare professionals for assessment and symptom control.
People were protected from the risk of infection by staff that complied with their infection prevention policy.
Staff understood their responsibilities under the Mental Capacity Act; they ensured that people consented to receiving care. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
This is the first time the service has been rated Requires Improvement.
You can see what action we told the provider to take at the back of the full version of the report.