9,10 July 2014
During a routine inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
The service was last inspected in June 2013 when we found it to be meeting all the regulations we reviewed.
This was an announced inspection. During the visit we spoke with 17 people who used the service, eight relatives, 12 staff, and a health professional. There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.
Places for People Individual Support Ltd is registered to provide personal care for people who live at Kingsway extra care housing scheme, Blackburn. Under this registration Places for People are also permitted to provide personal care for people who live at St Margaret’s Court extra care housing scheme, Blackburn. At the time of our inspection there were 48 people using the service across both sites.
People told us contradictory things about the service provided by Places for People. While most people who used the service told us they were generally happy with the care they received from Places for People staff, three people told us they felt staff were often rushed. One relative told us they felt staff were not caring enough and did not spend enough time with their family member.
People’s safety was being put at risk due to the lack of permanent staff, particularly at nights. This meant people had received care from staff who did not listen to them or understand their needs. A number of medicines errors had also occurred due, in part, to the fact that some agency staff lacked the necessary knowledge and skills to safely administer medicines.
Most of the people we spoke with expressed some concern about agency staff. Although we were aware the registered manager had taken steps to improve the staffing situation, we could not be certain that people who used the service would always receive safe and appropriate care.
Although staff were aware of the need to support people to make their own decisions wherever possible, not all staff had undertaken training to help them understand their responsibilities under the Mental Capacity Act 2005 should they assess that people lacked the capacity to make certain decisions.
There were systems in place to provide staff with support, induction, supervision and appraisal. Staff told us they enjoyed working at both Kingsway and St Margaret’s Court and considered they received the support they needed to effectively carry out their role.
Senior staff in the service conducted checks and audits to monitor the performance of staff. When necessary, supervision and appraisal systems were used to review practice or behaviour.
People’s health needs were assessed and people were supported to access appropriate services to meet these needs. Where appropriate, staff provided support to ensure people’s nutritional needs were met.
Records we looked at showed people’s care plans and risk assessments were updated to reflect their changing needs. We saw people had been involved in reviewing and providing feedback on the care and support they received.
The registered manager investigated and responded to people’s complaints in line with the provider’s complaints procedure. All the people we spoke with knew how to make a complaint and were confident their concerns would be taken seriously.
There were a number of quality assurance processes in place at the service. The registered manager had also introduced initiatives to develop best practice in caring for people with a dementia.
Staff told us they enjoyed working for the service and were always able to approach senior staff for advice or support. All the staff we spoke with told us they would feel confident to report any concerns about the conduct of other staff. From information we had received prior to the inspection we were aware that, when any concerns had been raised, the registered manager had taken appropriate steps to thoroughly investigate the matter.