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Archived: Lancaster Inadequate

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Inspection report

Date of Inspection: 10 September 2014
Date of Publication: 11 October 2014
Inspection Report published 11 October 2014 PDF | 92.75 KB


Inspection carried out on 10 September 2014

During an inspection in response to concerns

This was a responsive inspection because we had received information of concern regarding this agency. This related to an increase in safeguarding incidents and concerns raised by some people who used the service and their relatives.

During our inspection we looked at the systems the agency had in place to keep people safe and well. We looked at care plan records and risks assessments, safeguarding systems in place, management of medication, staff recruitment and induction training, the quality monitoring systems and how complaints were managed by the agency.

This helped to answer our five questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found.

Is the service safe?

Following a recent safeguarding meeting, the agency had devised a policy and guidance for staff to follow when supporting people who may lack the capacity to make decision regarding their care and support. The management team had recently attended training to develop their skills and knowledge in this area. We discussed with the provider the need to embed this learning and practice within the care and support they provide. The provider told us they would review their care plans to ensure mental capacity assessments are incorporated into their support plans.

We looked at several care plan records to show us how the agency supported people to remain safe and well in their home. Information in the care plans identified the care and support people required. The agency worked with a range of external professionals to meet people`s needs. Care plan records and risk assessments were regularly reviewed.

All staff had attended recent safeguarding training. Our discussions with staff confirmed they were aware of their responsibilities to report any concerns if they suspect someone is at risk of harm or abuse.

Is the service effective?

People's health and care needs were assessed, monitored and reviewed. The agency worked in partnership with other professionals. We received some positive comments from people. One person told us, “My family member is really happy with the agency and feels it is the best thing that has happened to her. If there are any problems they don`t hesitate to contact us.”

Is the service caring?

Staff we spoke with told us they felt well supported and enjoyed their work. They appeared to be caring and enthusiastic. Our discussions confirmed staff were knowledgeable regarding people`s needs and what actions to take if they had any concerns.

We saw documentation to show that staff completed daily records of their visits, and daily food and fluid charts. However the food and fluid charts and daily records we read were fairly basic. The Care Manager told us he would ensure that staff completed more detailed records by documenting what people actually ate and drink, and whether they required additional support to eat and drink. One person we spoke with told us, “I have been with the agency for a few months and they are a lot more on the ball. They help me at mealtimes and we have been bouncing ideas off to help me with seasonal variations with my meal planning. They are very encouraging”.

Is the service responsive?

Staff told us they regularly support people with Dementia type conditions. They told us their dementia training assisted them to meet the needs of people. Staff told us that the agency carried out spot checks and visits in people`s homes to gain feedback from people and to check that the care plan records were completed properly.” One person told us, “Generally the girls are very good. They are diligent, reliable and honest and that`s all we want. Sometimes the staff change when people don`t turn up or go off sick. However since I rang the office a few weeks ago they do try to ring and let us know.”

Staff were now attending annual e- learning refresher training in the management of medicines. We saw records in the staff files that indicated staff had recently undertaken and passed this training. We spoke with several members of staff. Our discussions confirmed they were aware of what actions to take to promote people`s health and well- being and what actions to take if they had any concerns.

Is the service well-led?

The agency had a range of systems in place to monitor the quality of the services being provided. They had introduced a new out of hours service to improve the communication with clients and their families. This benefited staff too, by giving them a dedicated resource for advice and guidance.

The agency had safe recruitment processes in place and had recently recruited new staff to the team. There was a recently appointed Care Manager in post who was being supported to develop their role. We saw evidence to show how he had responded positively to concerns and action taken to make improvements with the services they provide.