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Archived: SENSE - Community Services (North) Good

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Good

Updated 6 December 2016

The service provides domiciliary care to two people with sensory impairments in their own homes. Both people also attended a day service run by the provider but we did not inspect this as it was outside the scope of our regulations. The domiciliary service was last inspected on 6 February 2014 and met all the regulations we inspected at that time.

This inspection took place on 14 September 2016 and was announced.

A registered manager was in post. 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 2008 and associated Regulations about how the service is run.

There were safeguarding policies and procedures in place and staff had received training related to the safeguarding of vulnerable adults. Safe recruitment practices were following which helped to protect people from abuse. There were suitable numbers of staff working in the service. Regular staff visited people to maintain consistency and to avoid causing distress to people.

A policy was in place for the safe administration of medicines, and we spoke with staff who confirmed that medicines were appropriately stored, administered and recorded. A lone working policy was in place which recognised the potential risks to staff who were working in isolation away from other colleagues. On call managerial support was available to staff out of hours.

Risks in people's homes had been assessed, as had individual risk to people including those related to health needs or behavioural disturbance and distress. Person centred support plans were in place which detailed the support needs of people, and how staff should interpret the individual communication by people which could indicate their happiness or discontent in a situation. People were supported with eating and drinking, and training and competency assessments had been carried out to ensure staff could do so safely where people required specialist support such as enteral feeding [through a tube in the abdomen].

Staff received regular training, supervision and appraisals. Staff meetings were also held. Staff were line managed on a day to day basis by the day centred managers where they also worked, and did not have regular contact with the registered manager.

Staff were caring and respectful in their discussions about people who used the service. Care records were also sensitively written and courteous. The privacy and dignity of people was maintained and people were afforded maximum independence and privacy within clear boundaries for safety.

The registered manager was not taking day to day charge of the service when we carried out the inspection. They explained to us that they had taken on a regional operational role which prevented them from doing so and that they planned to de register with the Care Quality Commission [CQC]. Responsibility for the day to day running of the service had been delegated to two day services managers who were not registered with CQC. They took responsibility for monitoring staff training, carrying our supervision, appraisals and competency assessments, holding staff meetings, monitoring care and support plans and responding to enquiries from family members. Although the registered manager could be contacted for advice and support when necessary, we judged that they were unable to provide sufficient managerial oversight of the service due to their other commitments and responsibilities. Quality assurance systems were insufficiently structured to ensure the quality and safety of the service, and the responsibility for carrying out certain checks and audits was unclear. We have made a recommendation about this.

Inspection areas

Safe

Good

Updated 6 December 2016

The service was safe.

Safe recruitment procedures were followed which meant people were protected from abuse.

Risks to people were assessed and reviewed to ensure the safety of people who used the service. The safety of staff was also considered and there was a personal safety and lone working policy in place.

Medicines were managed safely and a procedure was in place to ensure the competency of staff administering medicines.

Effective

Good

Updated 6 December 2016

The service was effective.

The service was operating within the principles of the Mental Capacity Act and staff had received training. Guidance was available for family carers which explained the act.

Staff received regular training, supervision and appraisal. New systems were being developed to ensure that staff training was clearly documented and easy to interpret.

People were supported with eating and drinking and specialist support was sought if required.

Caring

Good

Updated 6 December 2016

The service was caring.

Staff spoke respectfully about people and language used in care records was sensitive and courteous.

The privacy and dignity of people was maintained. They were afforded maximum independence and privacy, whilst ensuring safety was not compromised.

No one was accessing any formal advocacy at the time of the inspection. A service user reference group attended services and meetings within the organisation to represent the views of people who used the service.

Responsive

Good

Updated 6 December 2016

The service was responsive.

Person centred care plans were in place which were up to date and regularly reviewed. A relative told us they were involved in regular reviews of the care and support provided.

People were supported to take part in the activities identified in their support plan, or could choose how to spend their time.

A complaints procedure was in place and the provider shared compliments and complaints received nationally to enable wider learning at local level. Compliments were also shared and celebrated.

Well-led

Requires improvement

Updated 6 December 2016

Not all aspects of the service were well led.

A registered manager was in post but they did not take day to day charge of the service. They had recognised that they were unable to provide the level of management necessary so had applied to CQC to de register as the manager of the service.

There were some quality assurance systems in place, but the person responsible for carrying out these checks was unclear, and they were not always clearly documented.

Staff told us they felt well supported and a relative told us they had no concerns about the quality of the service.