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Archived: PiCAS Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 12 April 2016

This inspection took place on 10 February and 3 March 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service in people’s own homes and we needed to be sure that someone would be available to assist with the inspection. The provider has now moved office and their new address is 221 Aldborough Road South, Ilford, Essex, IG3 8HZ.

PiCAS is registered to provide personal care to people their own homes. At the time of the inspection they were providing a supported living service to 12 people. Supported living is where people live in their own home and receive care and/or support in order to promote their independence. Some people lived in a house that they shared with another person who used the service but most people lived on their own.

The service has a registered manager. 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 registered manager is also the registered provider.

We found that the quality of the service provided varied between different supported houses.

Relatives were happy with the quality of care and felt that people had benefitted from the service provided to them. One relative told us that the service was marvellous. However, feedback from some health and social care professionals was that the service needed to improve to ensure people were supported safely in ways that met their needs.

Although people were encouraged to make choices and to have as much control as possible over what they did and how they were supported, systems were not in place to ensure that their human and legal rights were protected.

People did not consistently receive a safe service. Systems were not in place to ensure that people were protected from the risk of abuse. This was because although incidents were recorded they were not reported to the placing authority, to the local authority safeguarding team or to the Care Quality Commission.

The systems for staff summoning assistance in the event of an incident or emergency were not robust enough. We have recommended that these be reviewed and changed to ensure that help can be summoned when needed.

Systems were in place to ensure that people received their prescribed medicines safely and appropriately. Medicines were administered by staff who were trained to do this.

Staffing levels were sufficient to meet people’s needs and to enable them to do be supported flexibly and in a way that they wished.

The staff team did not always receive the training they needed to ensure that they supported people safely and competently. We have recommended that the training programme be reviewed to ensure that staff receive all of the necessary training in a timely way.

People were protected by the provider’s recruitment process which ensured that staff were suitable to work with people who need support.

People were encouraged to develop their skills and to be as independent as possible. One person said, “Staff have motivated me. I do what I want to do.”

Systems were in place to support people with their nutritional needs. They were supported to shop and cook for themselves according to their ability.

The registered manager monitored the quality of the service provided and sought feedback from people about the service.

Staff told us that they received good support from the registered manager. They were confident that any concerns raised would be addressed. People who used the service and their relatives also felt able to talk to the registered manager and said that any issues were dealt with quickly.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and one of the Care Quality Commission (Registration) Regu

Inspection areas

Safe

Requires improvement

Updated 12 April 2016

The service provided was not always safe. People were not protected from abuse because appropriate action was not taken to identify the possibility of abuse and prevent it from happening.

Staffing levels were sufficient to support people safely.

The systems for staff summoning assistance in the event of an incident or emergency were not robust enough. We have recommended that these be reviewed and changed to ensure that help can be summoned when needed.

People were supported by staff to receive their medicines appropriately and safely.

The provider�s recruitment process ensured that staff were suitable to work with people who need support.

Effective

Requires improvement

Updated 12 April 2016

The service provided was not always effective. The staff team did not always receive the training they needed to ensure that they supported people safely and competently. We have recommended that the training programme be reviewed to ensure that staff receive all of the necessary training in a timely way.

Systems were in not place to ensure that people�s human and legal rights were protected.

People�s healthcare needs were monitored and they were supported and encouraged to access healthcare services.

Systems were in place to support people with their nutritional needs.

Caring

Good

Updated 12 April 2016

The service provided was caring. People were happy with the way staff treated them.

People were supported to be as independent as possible.

People�s cultural and religious needs and wishes were identified and they were supported to meet these.

People were supported to maintain relationships with their friends and family.

Responsive

Requires improvement

Updated 12 April 2016

The service was not consistently responsive. We found that some people were involved in activities within their home and in the community and were supported to do what they wanted and liked. However, for others activities were very limited.

People were encouraged to make choices about what they did and how they were supported.

Some aspects of people�s care plans were detailed and gave a picture of how people wanted and needed to be supported. However, they did not give staff clear or detailed guidance about how to manage people�s more complex behaviours that challenged.

People were supported and encouraged to raise any issues that they were not happy about.

Well-led

Requires improvement

Updated 12 April 2016

The service was not consistently well-led. Although relatives and staff were positive about the management of the service some health and social care professionals expressed their concerns particularly in relation to safeguarding incidents.

The registered manager had not made the legally required notifications to the Care Quality Commission.

The registered manager monitored the quality of the service provided and sought feedback from people about the service.

Staff told us that the registered manager provided clear guidance and that they were aware of what was expected of them.