Background to this inspection
Updated
11 January 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 3 November 2015 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that staff would be in the office. We returned to the service announced on 11 November 2015 to look at more records.
The inspection team consisted of an inspector and an expert-by-experience. An expert-by-experience (ExE) is a person who has personal experience of using or caring for someone who uses this type of care service. Our ExE had experience of adult social care and domiciliary care services.
Before our inspection we reviewed information we had received about the service. This included feedback from a relative of a person using the service. We also received information from the provider about operational difficulties they were experiencing as a result of almost half of the workforce, including the registered manger, leaving the service. This information resulted in us bringing forward a planned inspection of the service.
We spoke with eight of the 14 people using the service at the time of our inspection and relatives of five people. We looked at three people’s care plans. We looked at how home visits were planned and records associated with those visits. We spoke with three care workers, the acting manager and the registered provider. We looked at a staff recruitment file and evidence of staff training. We spoke with the provider about their quality assurance procedures.
Updated
11 January 2016
We made an announced inspection of the service on 3 November 2015 and returned announced on 11 November 2015.
Kingfisher Care (Midlands) Limited is a small home care agency providing personal care to people who live in their own homes. At the time of our inspection 14 people were using the service. During our inspection we learnt that the service was transferring its office from 8 Robinson Way, Burbage to Unit 35, Sparkenhoe Business Centre, Southfields Road, Hinckley LE10 1UB. We advised the provider that they were required to formally notify the Care Quality Commission of the change to their location.
The service had a registered manager until they resigned in October 2015. 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. An interim manager was appointed to manage the service pending the appointment of a registered manager.
People using the service were safe because staff understood their responsibilities for safeguarding people from abuse and avoidable harm. However, the provider had identified that people’s care plans and risk assessments associated with people’s care routines were not always accurate or up to date. The provider had commenced a comprehensive review of all care plans.
The provider had effective recruitment procedures which they improvised during the period the service was left with few care workers. This enabled the provider to have enough care workers to cover scheduled home care visits. New staff with existing Disclosure Barring Service checks were allowed to support people after appropriate risk assessments were carried out.
The provider was able to deploy enough staff to make all scheduled home care visits, though not all visits were made at times people expected during October 2015. There had been an occasion in October 2015 when an untrained care worker was involved in administration of medicine, but no harm was caused to the person using the service.
People using the service were mainly supported by staff who understood their needs. However, during October 2015 when there was a high turnover of staff people felt they were supported by inexperienced staff. Staff had varied awareness of the Mental Capacity Act 2005. People’s care plans contained no information about whether they were presumed to have capacity to make decisions about their care or whether decisions about their care were made for them in their best interests. The provider was addressing this omission.
People using the service received support with meals. Care workers helped people prepare meals or they heated pre-pared meals for people. Care workers supported people to access health services if a need was identified during a care worker’s visit.
People told us that staff were caring. People developed caring relationships with care workers they had become accustomed to, but since several had left in October 2015 this process had restarted. The provider had procedures for involving people in decisions about their care and support. During our conversations with people, none said anything to suggest staff had not treated them with respect. However, two people’s privacy was not respected when staff made an unscheduled and unexpected visit that upset them.
People using the service contributed to the assessments of their needs when they first began to use the service and when their care plan was reviewed. The provider had begun a comprehensive review of all people’s care plans after identifying inaccuracies in a person’s care plan about how they needed to be supported.
People were able to raise concerns about the service. They were listened to and the provider acted upon what people said. The provider used an annual survey to obtain people’s feedback about the service.
The provider kept people using the service informed of operational difficulties that affected how the service was delivered. People using the service and staff had opportunities to be involved in the development of the service. The provider had reviewed their arrangements for monitoring the quality of the service after previous arrangements had lapsed. These arrangements were in their early stages but they were recognising signs of improvement.