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Coastal Carers Requires improvement

This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 21 November 2018

Coastal Carers was inspected on 11 and 17 September 2018. The inspection was announced on both days. Coastal Carers is a domiciliary care service. It provides personal care to people living in their own houses and flats in the community. It provides a service for older people and younger adults and people requiring support for their mental health, dementia, physical disability or sensory impairments. Not everyone using the service received a regulated activity; the Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Coastal Carers provides care for people living in the Scarborough and outlying areas including Cloughton, Snainton and Hunmanby. At the time our inspection 46 people were being supported by the service. Care visits were provided between 07:30- 21:30.

The service was run by a single provider in day to day control of the service. It was therefore not required to have a registered manager. The provider is an individual ‘registered person’. 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. The provider was supported to run and lead the service by two assistant managers.

At the last comprehensive inspection in May 2016 the service was rated good overall with requires improvement for the safe domain. At this inspection we found the service had not maintained this standard and rated it requires improvement. This is the first time the service has been rated requires improvement.

The provider had not submitted statutory notifications to the commission to notify us of the deaths of people using the service. This has been reviewed outside of the inspection process and is not being pursued.

The service supported people with medicines. Medication competencies were not in place to assess the ability of staff to deliver this care safely. On day two of the inspection we saw the assistant manager had added medication observations to the spot check form and had observed some staff providing this care.

Staff received training to provide them with the knowledge and skills required for their role. The service did not have any set mandatory training courses. We made a recommendation about training requirements.

Care documentation was not always in place. Where a person could present with behaviours that could challenge the service there was no positive behaviour support plan to help staff provide safe, consistent care to the person. Staff knew people’s life histories but this was not always recorded in people’s care files.

Care visits were provided at people’s chosen times and took into account any preferences they had for staff. The service was responsive when changes were made to people’s care arrangements due to changes in their needs or circumstances.

The service worked effectively as a team in partnership with people, their relatives and other organisations. Information was communicated within the staff team. Memos sent out to staff and team meetings were used to remind staff of best practice and discuss people’s needs. Staff knew when to contact health professionals if there were concerns about people’s health.

Representatives from the service attended multi- agency meetings such as safeguarding meetings and risk management meetings.

Staff built good, professional relationships with people. They understood their interests and supported them to participate in activities of their choice. Staff helped people maintain relationships with their family members.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Staff promoted people’s independence and encouraged them to

Inspection areas

Safe

Requires improvement

Updated 21 November 2018

The service was not always safe.

Risks to people were clearly identified and managed. Although, a positive behaviour support plan was not used to help support a person with behaviour that could challenge the service.

Medication competencies were not being used to observe and assess staff supporting people with medicines.

The service had sufficient numbers of suitable staff in place and was able to continue to work in adverse conditions.

People were protected against the risk of infection.

Effective

Good

Updated 21 November 2018

The service was effective.

The service did not identify training requirements expected of staff to support them in their roles.

People’s preferences for call times and staff were accommodated.

Staff worked with relatives, other services and as a team to deliver effective care.

Caring

Good

Updated 21 November 2018

The service was caring.

Staff formed relationships with people they supported and showed an interest in their lives.

People were supported to be independent and use their skills.

People’s emotional and communication needs were understood and care provided to support them.

Responsive

Good

Updated 21 November 2018

The service was responsive.

Personal histories were not consistently recorded and were being reviewed.

The service worked flexibly to accommodate changes in people’s care needs and care visits.

People were supported to pursue their interests and maintain relationships with those that mattered to them.

People knew how to make complaints. Complaints were acted on.

Well-led

Requires improvement

Updated 21 November 2018

The service was not always well-led.

Statutory notifications had not been submitted to the Care Quality Commission.

People had the opportunity to engage with the service through client questionnaires and direct contact with senior members of staff.

Team meetings were used to shared information about people’s needs and update staff on best practice.

Spot checks and medication audits were used to monitor and maintain quality standards within the service.