Archived: Empathy Care Services

A registered manager was in place. 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. The previous inspection was carried out in March 2016 to follow up Warning Notices issued at the comprehensive inspection of November 2015 with regard to providing safe care and ensuring a quality service. We found the warning notices had been complied with. At the last comprehensive inspection of November 2015, we asked the provider to take action to make improvements to people’s personal care, and this action has largely been completed.

People and relatives we spoke with told us they thought the service ensured that people received safe personal care. Staff had been trained in safeguarding (protecting people from abuse) and staff understood their responsibilities in this area.

We saw that medicines were, in the main, supplied safely and on time, to protect people’s health needs though improvements to records were needed.

Risk assessments were not always comprehensively in place to protect people from risks to their health and welfare. Staff recruitment checks were in place to protect people from receiving personal care from unsuitable staff.

Staff had received training to ensure they had skills and knowledge to meet people's needs, though this had not always covered some relevant issues.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have effective choices about how they lived their lives, though assessments of people's capacity had not been in place to ensure people's ability to make decisions was comprehensively protected.

People and relatives we spoke with all told us that staff were friendly, kind, positive and caring. They told us they had been involved in making decisions about how and what personal care was needed to meet care needs.

Care plans were individual to the people using the service to ensure that their needs were met, though they did not include all relevant information such as people's past histories.

People and relatives told us they would tell staff or management if they had any concerns, they were confident these would be properly followed up. Evidence of complaints made had not always showed they had been properly investigated.

People and their relatives were satisfied with how the service was run. Staff felt they were supported in their work by the senior management of the service.

Management carried out audits in order to check that the service was meeting people's needs and to ensure people were provided with a quality service, though action was not always shown to be taken for some issues.

We previously carried out an unannounced inspection of this service on 23 November 2015. Three breaches of regulations were found, two of which led to warning notices being issued, and the service was judged to be ‘Requires Improvement’ overall.

The warning notices were issued because the registered person did not have effective systems and processes in place to ensure people using the service were provided with safe care. They also did not have appropriate systems in place to enable them to assess, monitor and improve the quality of the service provided in the carrying out of the regulated activity.

After this inspection we asked the provider to produce an action plan stating what they would do to meet legal requirements in relation to the breaches. The provider sent this to us. This outlined action that would be put in place to ensure that these breaches in regulations were rectified.

We undertook this focused inspection on 24 March 2016 to check that the provider had now met legal requirements with regard to the warning notices. This report only covers our findings in relation to the warning notices. We will check the other issues at a future inspection.

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

Focused inspections evaluate the quality and safety of particular aspects of care. They take place when we are following up after a comprehensive inspection, or when we have received concerns and have decided to look into them without doing a comprehensive inspection of all aspects of the service. They only ask the relevant key questions, rather than all of them.

The provider informed us on the day of the inspection that Empathy Nursing and Social Care provided personal care for 40 people living in their own homes. The agency is situated in a city centre location in Leicester City.

A registered manager was in place. 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.

On this inspection we found the provider had taken action to meet these breaches of the Health and Social Care Act 2008 Regulated Activities Regulations 2014 with regard to having systems in place to provide safe care, and there was a quality assurance system in place to check that personal care had been properly supplied to people using the service.

People using the service and the relatives we spoke with said they thought the agency ensured that people received safe personal care.

Risk assessments for people were in place to help ensure staff understood how to support people safely.

Staff had been safety recruited to help ensure they were appropriate to work with the people who used the service.

People and relatives we spoke with told us they liked the staff and got on well with them, and we were told of examples of staff working with people in a friendly and caring way.

Management carried out audits and checks to ensure the agency was running properly.

The detailed evidence supporting our summary please can be read in our full report.

Is the service safe?

People told us they felt safe. One relative told us his mother had not felt safe because of the actions of a staff member. The manager told us that the safeguarding authority were investigating these concerns and the staff member had been suspended from duty pending this investigation.

People told us that they felt their rights and dignity were respected.

Staff were aware about care plans and risk management plans that had been written for some people with particular needs. This provided protection to people from unnecessary risk of harm.

Recruitment practice was generally safe.

Is the service effective?

People's health and care needs had been assessed and care plans were found to be in place. There was evidence of people being involved in assessments of their needs and planning their care. People told us that staff had spoken with them about their care needs. Dietary needs were assessed and included in care plans, though more detail was needed in some plans to ensure people received the right care. Detailed individual information about a person with dementia had not been included in the care plan. This would have assisted staff to have effectively communicated with the person and provide more opportunities for stimulation. It was therefore not possible to confirm that all people's needs were being met.

Is the service caring?

Four people told us about the staff supporting them. They told us that: 'staff are good. They try their best and are friendly' and 'staff help me. I have no problem with them.'

Not all people using the service, or their relatives, had completed an annual satisfaction survey. No action plan had been produced for the small number of questionnaires that we saw, so there was a risk that not all issues had been dealt with. The registered manager told us he would be developing an action plan in future to ensure people received good quality care.

Is the service responsive?

People said that they could make a compliant if they wanted to, but no one we spoke with had needed to. People told us when they told management about anything that had concerned them, it had been quickly put right. They were satisfied with the outcome of their concerns.

Is the service well-led?

Staff told us that if they witnessed or heard of poor practice they would report their concerns to their management.

The service had a quality assurance system. However, the system did not cover all essential processes with regard to the running of the agency, so there was a risk that people may not had received high quality services at all times.

There were suggestions made by relatives we spoke with; that communication from head office needed to be improved so that people know if staff were running late, and that staff needed to be careful when using a wheelchair so they did not damage paintwork to doorways.

People who used the service, or their representative, had signed a formal contract to confirm they agreed with the arrangements that were in place for the provision of their care and support.

Care plan documents had been updated at regular intervals and reflected peoples' current circumstances. People who used the service, and relatives of these people, told us that they received the support they needed and staff followed the routines that were outlined in the care plans.

There was no clear written information for staff to explain the types of abuse that a vulnerable person who used the service may be at risk of. Neither was there any written information to explain what action they should take if they had concerns about the welfare or safety of a person they supported.

The provider had not always completed sufficient checks to ensure that prospective employees were suitable for the role. The provider had also not checked that staff had relevant and up to date training, skills and knowledge.

Regular checks were carried out to help ensure that the service was delivered reliably and that staff were performing their duties well.

The member of staff told us people were encouraged to make choices about all aspects of their care and support. They said, 'The person I work with knows what they want and is very particular about their care. They make choices about what to eat, what to wear, and what type of care they need. I always respect their choices and understand it's up to them how their care is provided.'

We visited the agency's offices to look at records and talk to the manager about how staff provided safe and appropriate care to people. The manager told us care plans were produced in consultation with the person using the service and included information about their care needs, wishes, preferences, and personal goals.

The member of staff told us they felt well supported by the agency. They said, 'I meet with the manager once a week to discuss my work and he is always available by phone if I need him.' The manager told us he had already visited the person who used the service to check they were satisfied with their care.

The agency's offices have parking directly outside the building, level access, and a lift. This means that people with limited mobility who want to visit the offices are able to do so.