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Archived: 1st Calder Care Ltd Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 20 October 2018

1st Calder Care is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to people over the age of 18 years. Not everyone using 1st Calder Care receives 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 were 13 people receiving personal care when we inspected.

This inspection took place on 7 and 8 August 2018 and was announced. The provider was given short notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies to make sure the registered manager would be available.

At our previous inspection in January 2018 we rated the service as ‘Requires Improvement’. We identified four regulatory breaches which related to safe care and treatment, staffing, person-centred care and good governance. This inspection was to check improvements had been made and to review the ratings.

The registered manager who was in post when we inspected in January 2018 left the service. A new manager was employed who registered with the Commission in July 2018. 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.’

Although we found some improvements had been made at this inspection, concerns remained in several areas. We found continued regulatory breaches in relation to safe care and treatment (medicines), person-centred care, staff training and good governance. We also identified two new breaches in relation to staff recruitment and consent.

Medicines management was not safe as records were incomplete. This meant we could not be sure people were receiving their medicines as prescribed.

Not all staff had a full understanding of safeguarding or had received training in this area. Safeguarding incidents were reported to the local authority safeguarding team. Assessments identified risks to people, although some of these required more detail to show how the risks were managed.

Staff recruitment procedures were not robust as thorough checks had not been completed before staff started working in the service. Moving and handling training had improved, however, staff had not always received the induction and training they required to carry out their roles.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

There were sufficient staff to meet people’s needs and provide a flexible service. People and relatives were happy with the service provided. They told us staff usually arrived on time and stayed the full length of the call. They said staff were caring and respected people’s privacy and dignity. People’s nutritional needs were met and people had access to healthcare services.

People’s care plans contained basic information but there was a lack of detail to guide staff during care delivery and some aspects of people’s needs were not included in the care plan. There was not enough detail to guide staff about the care and support people required.

The registered manager told us there had been no complaints, however, we found two complaints. Although both had been dealt with they had not been recognised as complaints or recorded as such. The provider’s systems and processes did not enable them to effectively assess, monitor and improve the service.

The Care Quality Commission is considering the appropriate regulatory response to resolve the problems we found.

Inspection areas

Safe

Inadequate

Updated 20 October 2018

The service was not safe.

Medicines management was unsafe as we could not determine if people were receiving their medicines as prescribed.

Staff recruitment processes were not robust.

There were enough staff to ensure people usually received their calls on time and for the correct duration.

Safeguarding incidents were reported appropriately, although not all staff had received safeguarding training. Risks to people's health, safety and welfare were not always fully assessed and mitigated.

Effective

Inadequate

Updated 20 October 2018

The service was not effective.

Staff had not received the training and support they required for their job role and to meet people's needs.

People's rights were not always protected because the registered manager and staff did not understood their responsibilities under the Mental Capacity Act 2005.

People received support to ensure their healthcare and nutritional needs were met

Caring

Good

Updated 20 October 2018

The service was caring.

People said the staff were kind and caring.

People's privacy and dignity was respected.

Responsive

Inadequate

Updated 20 October 2018

The service was not always responsive.

People's support plans were not always person-centred and did not show the support people required on each call.

Complaints were not formally captured on the complaints record.

Well-led

Inadequate

Updated 20 October 2018

The service was not well led.

People were happy with the way the service was managed. However, there remained significant shortfalls in the governance arrangements which failed to identify and rectify the issues we found at this inspection.