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Siete Care Services Requires improvement

Reports


Inspection carried out on 23 September 2020

During an inspection looking at part of the service

About the service

Siete Care Services is a domiciliary care agency (DCA). The service provides personal care services to people in their own homes.

At the time of our inspection nine people received personal care as the regulated activity. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. The last rating for this service was Good (Report published 17 May 2019).

People's experience of using this service

Medicines were administered safely. However, medicine records were not always accurate and up to date. Staff’s competency to safely administer medicine was regularly checked and recorded.

The registered manager had quality assurance systems in place to monitor the quality and safety of the service. This included monitoring of medicine management. However, these systems were not always effective and did not identify our concerns in relation to medicine records. The registered manager took action to rectify these concerns.

The service had a clear management and staffing structure in place and promoted a positive, caring culture.

People told us they felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. People had risk assessments in place to enable them to be as independent as they could be in a safe manner.

There were sufficient staff on duty to support people with their needs and keep them safe. Effective and safe recruitment processes were followed by the provider. Some historical recruitment documents were not fully completed. Following the inspection we were informed action had been taken to update these records.

People were safe from the risk of infection. This included measures introduced by the provider to safeguard people and staff from COVID-19.

We undertook this focused inspection following concerns raised by the local authority. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the Well-Led section of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Siete Care Services on our website at www.cqc.org.uk.

Inspection carried out on 2 May 2019

During a routine inspection

About the service.

Siete Care Services Limited is a domiciliary care service supporting people in their own homes in the Oxfordshire area. At the time of our announced inspection the service supported one person.

People’s experience of using this service:

• The person was safe. There were enough staff to meet this person’s needs. Staff were aware of their responsibilities to report concerns and understood how to keep this person safe. We saw that risks to safety and well-being were managed through a risk management process. There were systems in place to manage safe administration of medicines.

• The person had their needs assessed prior to receiving care to ensure staff were able to meet their needs. Staff worked with various local social and health care professionals. Referrals for specialist advice were submitted in a timely manner.

• The person continued to be supported by staff that had the right skills and knowledge to fulfil their roles effectively. Staff told us they were well supported by the management team.

• Staff had been trained to meet the person’s nutritional needs, so they maintained an enjoyable and varied diet.

• The person were treated with respect and their dignity was maintained. They were also supported to maintain their independence. The provider had an equality and diversity policy which stated their commitment to equal opportunities and respecting diversity. Staff knew how to support the person without breaching their rights. The provider had processes in place to maintain confidentiality.

• This person was supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

• This person and their relatives knew how to complain, and a complaints policy was in place. Their input was valued, and they were encouraged to feedback on the quality of the service and make suggestions for improvements.

• The service was well-led. The person, relatives and staff were complimentary of the registered manager and the management team. The registered manager promoted a positive, transparent and open culture where staff worked well as a team. The provider had effective quality assurance systems in place which were used to drive improvement. The provider worked well in partnership with other organisations.

The service met the characteristics of Good in Safe, Effective, Caring, Responsive and Well-led. At last inspection on 15 February 2018 we asked the provider to make improvements in relation to risk assessments to manage people’s safety and quality monitoring systems used to improve the service. These actions have been completed.

The service has improved to Good.

Rating at last inspection: Requires improvement. Report published 1 March 2018.

Why we inspected:

This was a planned, routine inspection.

Follow up:

We will monitor all information received about the service to understand any risks that may arise and to ensure the next planned inspection is scheduled accordingly.

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

Inspection carried out on 15 February 2018

During a routine inspection

We undertook an announced inspection of Peacefulliving on 15 February 2018.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community [and specialist housing]. It provides a service to older adults in Banbury, Oxfordshire and the surrounding area. At the time of our inspection three people were being supported by the service.

There was a registered manager in post. 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.

Where risks to people had been identified, risk assessments were in place and action had been taken to manage the risks. However, risk assessments were not always accurate or up to date and did not always provide staff with adequate guidance to manage these risks. Some risk assessments were generic and not personalised.

People told us they benefitted from caring relationships with the staff. There were sufficient staff to meet people’s needs and people received their care when they expected. Staffing levels and visit schedules were consistently maintained. The service had safe, robust recruitment processes.

People were safe. Staff understood their responsibilities in relation to safeguarding. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the appropriate authorities where concerns were identified.

At the time of our inspection none of the people using the service were supported with medicine. People told us their relatives supported them with medicine.

Staff had a good understanding of the Mental Capacity Act (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves. The registered manager was knowledgeable about the MCA and how to ensure the rights of people who lacked capacity were protected.

People were treated as individuals by staff committed to respecting people’s individual preferences. The service’s diversity policy supported this culture. Care plans were person centred and people had been actively involved in developing their support plans.

People told us they were confident they would be listened to and action would be taken if they raised a concern. We saw a complaints policy and procedure was in place. The service had systems to assess the quality of the service provided. Learning was identified and action taken to make improvements which improved people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the registered manager. Staff supervision and meetings were scheduled as were annual appraisals. Staff told us the registered manager was approachable and there was a good level of communication within the service.

People told us the service was friendly, responsive and well managed. People knew the managers and staff and spoke positively about them. The service sought people’s views and opinions and acted upon them.

We identified one breach of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2014. You can see what action we have required the provider to take at the end of this report.