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Coastal Carers Requires improvement

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

Reports


Inspection carried out on 11 September 2018

During a routine inspection

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 carried out on 21 December 2016

During an inspection to make sure that the improvements required had been made

We carried out an announced comprehensive inspection of this service on 8 March 2016. A breach of legal requirements was found in relation to staff recruitment. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Coastal Carers on our website at www.cqc.org.uk.

Coastal Carers provides a domiciliary care service offering support and personal care to adults who live in their own homes in Scarborough and surrounding area. On the day of inspection they were providing a service to 76 people.

There was a registered manager 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 2008 and associated Regulations about how the service is run.

At this focused inspection we found that action had been carried out to improve the safety of staff recruitment. We examined recruitment records of the staff who had been employed since the last inspection. The registered manager ensured that they received information from the Disclosure and Barring Service (DBS) confirming that a full check had been carried out before permitting staff to begin their induction. The DBS check assists registered providers to make safer recruitment decisions by checking that prospective care workers are not barred from working with people who need social care support. This meant the registered provider now met legal requirements.

We have not improved the rating for safe from requires improvement because to do so requires consistent good practice over time. We will check this during our next planned comprehensive inspection.

Inspection carried out on 8 March 2016

During a routine inspection

This inspection took place on the 8 March 2016 and was announced.

Coastal Carers provides a domiciliary care service offering support and personal care to 76 adults who live in their own homes.

There was a registered manager in post at this service. 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.

Recruitment processes were not safe at this service and staff had started work before checks were completed to ensure they were suitable to work with people in their own homes. The provider had not followed robust processes to gather appropriate information about people they employed. You can see what action we told the provider to take at the back of the full version of the report.

Staff received training that was relevant to their roles. There were sufficient staff employed to meet people’s needs. They were supported through regular supervision with senior staff.

Care plans were detailed, had associated risk assessments in place and people were involved in their content and review. Medicines were managed safely and we found there had been a reduction in medication errors.

People who use the service were encouraged by staff to live as independently as possible and people told us they felt they were treated with dignity and respect. People told us the staff approach was caring and made positive comments about the care they received.

The service was led by a registered manager and team of supervisors who had experience of working with people and held appropriate qualifications.

The registered manager had historically made appropriate notifications to CQC. However, we found an oversight relating to notifications not being made promptly and the registered manager rectified the issue immediately.

Audits were completed regularly and people who used the service were asked for their views and suggestions via questionnaires. Responses were recorded and actioned in order to maintain the quality of the service. People told us that the management team were approachable.

Inspection carried out on 25 February 2014

During an inspection to make sure that the improvements required had been made

We carried out this inspection to check that the service had improved following an inspection in October 2013 when areas of non-compliance had been identified.

People who spoke with us said that they either administered their medication independently or that staff supported them in taking their medication. They told us that staff made sure that medication was taken at the correct time. We saw that the provider had worked with the North Yorkshire and Humber community support pharmacist and the local authority to make improvements to practice.

There were effective recruitment and selection processes in place. When we spoke with people who used the service one person told us that staff were,"Excellent",another said "They are well trained and do everything I ask" and a third said," I think staff are pretty well trained.The majority are caring and careful".Staff received appropriate professional development.

Most of the staff had completed training in Manual handling,safe administration of medicines,food hygiene,fire safety, infection control,health and safety,safeguarding,deprivation of liberty,dementia awareness and first aid during the current year.

We found that the service had worked hard to develop a robust quality assurance system for monitoring and assessing the service.

One person had said," I have found no faults with anyone.They work hard and fill their time.All the staff are very pleasant and friendly".

Inspection carried out on 22 October 2013

During an inspection in response to concerns

We carried out this inspection because we received some concerning information from the North Yorkshire County Council Contracting and Quality Assurance team following one of their monitoring visits.

People who used the service were potentially at risk of not receiving their medicines as prescribed as we found a lack of appropriate arrangements in place with regard to the management of medicines.

People who used the service were potentially at risk of receiving care from staff who were not considered suitable to work with vulnerable people as effective recruitment procedures and checks had not been undertaken before staff began work.

People who used the service were potentially at risk of receiving poor care as staff did not always receive timely induction and training to enable them to deliver care and treatment safely.

We found that improvements were needed to the quality assurance system to ensure people’s health, safety and care was monitored effectively and that appropriate action could be taken where necessary to make changes in the service.

We found that the provider/manager had taken on board the recommendations from the local authority visit in October 2013. We saw some evidence that action had been already taken to improve practices within the service and further action was planned.

Although we had concerns about the service, the people who used the service were very happy with the service they received. We spoke with five people who told us “The service is marvellous”, “Excellent service”, “I always get someone when I ask for extra care”, “Very good at arranging care when I come out of hospital” and “The staff go above and beyond my expectations.”

Inspection carried out on 10 April 2013

During a routine inspection

People told us they were happy with the care they received from Coastal Carers. One person told us "All the carers I have are marvellous." Another person told us "They understand the help we need and why we need it."

We found that people were consulted about their care and that the service sought people's consent to their care and treatment. We saw that the service assessed people's capacity to make decisions. When people were assessed to lack capacity and where decisions were needed about care and treatment, these made by a multidisciplinary team to ensure they were in the person's best interests.

We saw that the service assessed people's care needs and developed care plans which were reviewed with risk assessments in place. This meant that people received the care they needed.

We saw that people were protected from risk of harm through the correct recruitment practice and appropriate checks.

The service handled medication safely to protect people's health.

The service monitored the quality of its care and support through surveys and internal systems so that improvements could be identified and put in place.

Inspection carried out on 6 June 2012

During a routine inspection

We spoke with two people who used the service and two relatives of people who used the service. People told us they were consulted about their care and that their preferences were listened to and acted upon. They told us they received the care they needed and that staff took time to explain things and ask them what else they needed. They told us staff did not rush. One person told us, ‘The staff understand my medical condition and help me with the exercises I need to do. This is important to keep me flexible.' Another person told us, ‘They couldn’t be better.’