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Kare Plus Portsmouth Requires improvement

We are carrying out a review of quality at Kare Plus Portsmouth. 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 8 November 2018

This inspection took place on 27 September 2018 and was announced. Kare Plus Portsmouth is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults and younger adults who may be living with a disability or sensory impairment. At the time of inspection, the service was delivering personal care to 48 people living in their own homes.

There was a registered manager was in place at the service. 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.

This is our first inspection of the location since registration.

People’s medication records did not always reflect that they were administered safely. It was not always clear that people received their medications as prescribed. Risk assessments did not always provide sufficient information to provide direction for staff, or information about how to reduce risks.

The registered manager conducted some quality assurance audits to monitor the running of the service. However, these were not always affective and records didn’t always reflect these had been completed to monitor, assess and improve the quality of the service being delivered.

People and their relatives gave us mixed responses as to whether they felt staff had the skills and knowledge to support them. We made a recommendation about staff competence, skill and experience.

People and their relatives gave mixed feedback regarding whether they knew who was coming to provide care and whether they received the consistency of the same staff. We made a recommendation about the consistency of staff deployed to care for people.

People told us they felt safe. There were systems in place to protect people from the risk of abuse and potential harm. Staff were aware of their responsibility to report any concerns they had about people's safety and welfare.

Staff felt confident to use the whistleblowing policy if required and felt management would act on concerns.

The provider had continuity plans in place to ensure that people's support needs would still be met in emergency situations. Infection control policies and procedures were followed to ensure the control of infection.

Staff received an induction and ongoing training, to help them meet and understand the care needs of the people they supported.

People's nutritional needs were catered for and the level of support provided was dependant on people's abilities. Staff told us how they worked alongside people to prepare their own meals where they were able.

There was a complaints process in place and when there was a record of a complaint, the provider had taken action that was appropriate.

Staff had a good understanding of people's needs and were kind and caring. People told us that they were treated with dignity and respect.

The registered manager and the management team strived at creating an inclusive environment to strongly encourage staff, people and their relatives to be involved in the service.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Inspection areas

Safe

Requires improvement

Updated 8 November 2018

The service was not always safe.

People's medication records did not always reflect that they were administered safely. Guidance was not always available where people were prescribed 'as required' medication.

Records did not always reflect how the service was meeting people's specific health conditions. Staff were not always aware of how to support people with their specific health conditions.

Staff understood their responsibilities to keep people safe from abuse.

Staff felt confident to use the whistleblowing policy if required and felt management would act on concerns.

There was sufficient staff to meet people’s needs.

Effective

Good

Updated 8 November 2018

The service was effective.

People's needs were assessed for staff to support them effectively.

Staff enabled people to access health care services when needed.

People were supported with their food and hydration where needed.

Staff sought people's consent prior to supporting them.

Caring

Good

Updated 8 November 2018

The service was caring.

People spoke positively about the staff who supported them and described them as caring.

People were treated with dignity and respect and were supported to maintain their independence.

Staff enabled people to express their views and to make decisions about their support.

People's confidential information was stored securely.

Responsive

Good

Updated 8 November 2018

The service was responsive.

People's care needs were assessed and any changes to care needs were reviewed on a regular basis.

People were supported by staff who were aware of their preferences and how they wished to be supported.

People and their representatives were able to raise any concerns or complaints if they needed to.

Systems, policies and procedures were in place should any person need end of life care.

Well-led

Requires improvement

Updated 8 November 2018

The service was not always well-led.

Audit systems to monitor quality and safety were in place but they were not always effective in highlighting the issues which needed to be addressed.

Staff felt supported in their role and were complimentary of the registered manager.

There was not effective oversight of late and missed visits. People told us staff did not always arrive on time.

People told us they were always asked to provide feedback about the service.

The provider had informed us of incidents as required by the regulations.

People, relatives and staff were complimentary about the service.

Meetings were held where good practice was shared.