Archived: Palmerstone Homecare

People's experience of using this service

People received a safe service. Staff knew how to keep people safe and were knowledgeable of safeguarding procedures. Risks to people's safety were identified, assessed and appropriate action was taken to keep people safe. When people were at risk staff had access to assessments and understood the actions needed to minimise avoidable harm. There were always enough staff deployed to meet people's needs. Staff underwent relevant pre-employment checks that assured they were suitable to care for people made vulnerable by circumstances in their own homes. Medicines were administered and managed safely by trained and competent staff. The registered manager carried out audits of Medicine Administration Records (MAR).

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff were trained and supported to ensure they delivered effective care and support to people. This helped to ensure people received consistent and informed care, which they had agreed to.

Staff were respectful and caring towards people. Staff understood the importance of promoting equality and diversity. Staff knew how to communicate with people, which helped develop positive relationships with them.

People's care plans were personalised, and people were involved in decisions made about their care and support. People knew how to make a complaint about the service. Staff felt supported by the registered manager and other senior staff.

At our previous inspection we required further assurance that the service was sustaining all the improvements they had made. At this inspection we found that quality assurance systems were working more effectively. The registered manager was committed to developing and making continual improvements to the service.

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

Rating at last inspection

The last rating for this service was Good (published 03 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Palmerstone Homecare provides personal care to people in their own homes. At the time of inspection 178 people were using the service.

We carried out an announced comprehensive inspection of this service in July 2016 at their old location 8th Floor, North Suite, Terminus House, Terminus Street, Harlow, CM20 1XA due to concerns raised about the care and support provided. We reported that the registered provider was in breach of the Health and Social Care Act 2008 registration and regulated activities regulations.

Regulation 18 Registration Regulations 2009 Notifications of other incidents

Regulation 16 HSCA RA Regulations 2014 Receiving and acting on complaints

Regulation 17 HSCA RA Regulations 2014 Good Governance

Regulation 16 – Receiving and Acting on Complaints, Regulation 18 HSCA RA Regulations 2014 Staffing.

We took enforcement action and served two Warning Notice against two more serious breaches that we found in respect of Regulation 12 HSCA RA Regulations 2014 Safe care and treatment, and Regulation 19 HSCA RA Regulations 2014 Fit and proper persons employed. We gave the provider until 1 November 2016 to ensure they complied with the Warning Notices.

We asked the registered provider to make improvements and they sent us a comprehensive plan with the actions they intended to take. At this inspection, we found the service had made significant improvements and that all the breaches of regulation found in our visit in July 2016 had now been met.

There was a registered manager in post at the service. The registered manager was also the registered provider. 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 and associated Regulations about how the service is run.

There were new systems in place to monitor the quality of the service and a new computer system had been purchased which was intended to address many of the concerns we had raised previously. A significant number of changes had been introduced over a relatively short period of time. As a result, additional time was needed for these to become fully embedded and for the manager to be able to demonstrate that improvements were sustainable.

The registered manager and staff had taken steps to ensure that accurate medicines records were maintained and improved checks helped ensure people were receiving the medicines they needed. The registered manager had taken steps to ensure staff were aware of incidents that required notification to the Care Quality Commission (CQC) and the local safeguarding team. Management arrangements had been strengthened

Improvements had been made to the checks carried out on new staff to ensure recruitment was robust and safe.

The manager had revised risk assessments to ensure they were aware of how to support people to remain safe in their homes. There were sufficient staff to meet people’s needs and to manage risk safely.

Staff had access to relevant training and regular supervision to equip them with the knowledge and skills to care and support people effectively.

The legal requirements of the Mental Capacity Act 2005 (MCA) were followed when people were unable to make specific decisions about their care. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves.

People who needed support to ensure they had sufficient food and drinks received this. Staff kept records in relation to this, and where they had concerns, raised this appropriately. Staff worked in cooperation with health and social care professionals to ensure that people received appropriate healthcare and treatment in a timely manner.

Staff were kind and caring and treated people with dignity and respect.

There were improved systems in place to support people if they wished to complain or raise concerns about the service.

The provider had systems in place to monitor the quality and safety of the service provided and the provider had appropriately notified the Care Quality Commission of any significant events.