Archived: Kare Plus Portsmouth

People’s experience of using this service:

Insufficient improvement had been made since our last inspection. Medicines management remained unsafe. 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 continued to lack enough information to provide direction for staff, or information about how to reduce risks.

The registered manager had conducted some quality assurance audits to monitor the running of the service. However, these were not always effective, records did not always reflect these were used to monitor, assess and improve the quality of the service being delivered.

Despite this people’s relatives told us they felt their family member was safe. There were some 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.

People’s relatives and staff knew the registered manager and felt able to speak to them if they had any concerns. The registered manager demonstrated a willingness to make improvements and had recently employed a staff member who would be responsible for carrying out monthly audits.

Rating at last inspection: The service was rated Requires Improvement at their last inspection. (Report published 7 November 2018)

Why we inspected: At our last inspection we found Kare Plus Portsmouth was in breach of Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because they had not ensured the safe management of medicines, risks for people had not been assessed and plans implemented to reduce these and governance was poor meaning issues of concern were not being identified. We served a warning notice to the provider requiring them to be compliant with Regulation 12 by the 25 January 2019 and issued a requirement notice for regulation 17. We carried out this focussed inspection to check whether Kare Plus had acted to meet the warning and requirement notices issued at the inspection in November 2018.

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

Follow up: We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and because this is the second consecutive time the service has been rated as requires improvement we will request a clear action plan from the registered person on how they intend to achieve good by our next inspection. We may decide to meet with the provider following receipt of this plan. We will continue to monitor all information received about the service to understand any risks that may arise and to ensure the next inspection is scheduled accordingly.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

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.