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Carer House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 4 January 2020

About the service

Carer House is a domiciliary care service providing personal care to people living in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. The service was providing personal care to two people at the time of the inspection.

People’s experience of using this service and what we found

Risks had not always been managed effectively. People’s risk assessments contained conflicting information. Risks were identified during assessment visits. Actions had not been added to reduce or remove the risks to keep people and staff safe from harm.

Medicines were not always managed safely. The provider’s medicines policy did not relate to the domiciliary care service. The policy related to nursing and residential homes. This meant that staff did not have adequate guidance to carry out their roles safely. Training records showed that new staff had not completed medicines training. New staff told us they were applying creams and lotions.

Staff had not always been recruited safely to ensure they were suitable to work with people. The provider had not carried out sufficient checks to explore staff members' employment history to ensure they were suitable to work around people who needed safeguarding from harm.

Relatives told us that their loved ones had regular staff who they knew well. Their regular staff mostly arrived on time. However, sometimes they were late or they tried to leave early. We made a recommendation about this.

Staff told us they have been supervised and had spot checks of their practice when supporting people with their care needs. Staff supervision records did not evidence that issues identified during spot checks had been discussed and whether there was any further actions or training required as a result of this. We made a recommendation about this.

People were not always treated with dignity and respect. After our inspection a relative contacted us to explain that the lunchtime care staff booked to attend to their loved ones had not arrived. The provider’s call monitoring system had not alerted them to this issue. The provider was unaware of the concerns until the relative rang them. Although a replacement member of staff eventually attended this failure meant that staff did not always treat people with respect as people were left waiting for their care. This is an area for improvement.

The management team were responsible for creating and developing care plans and risk assessments. The provider was not fully aware of AIS. We referred them to information to help them create documents which met people’s communication needs. Care plans were not provided to people in a format which made it easy to read. This is an area for improvement.

At the last inspection we raised that the provider had not appropriately recorded informal complaints which meant that the provider did not have oversight of these and was not analysing trends. This had not improved at this inspection. We made a recommendation about this.

Quality monitoring processes were poor and did not provide the information the provider would need to be assured of the quality and safety of the service provided. The provider did not have sufficient oversight of service. The provider had not taken timely and sufficient action to address the shortfalls identified at the last inspection, which has led to continued breaches of regulations and new breach of regulation relating to risk management, medicines management and recruitment of staff. Records were not always accurate, complete or contemporaneous. There had been no robust audits or checks of the service completed since our last inspection by the provider.

People were not always supported to have maximum choice and control of their lives and staff did not support th

Inspection areas

Safe

Requires improvement

Updated 4 January 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 4 January 2020

The service was not always effective.

Details are in our effective findings below.

Caring

Requires improvement

Updated 4 January 2020

The service was not always caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 4 January 2020

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Inadequate

Updated 4 January 2020

The service was not well-led.

Details are in our well-Led findings below.