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Interserve Healthcare Liverpool Good

Inspection Summary


Overall summary & rating

Good

Updated 10 November 2018

The inspection took place on 9 and 11 October 2018. The inspection was announced.

Interserve Healthcare Liverpool is a domiciliary care agency providing nursing and personal care to adults and children in their own homes. At the time of the inspection the service was directly managing the provision of care to 12 adults and 14 children.

The service had a registered manager. A registered manager is a person who has registered with CQC 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.

The service had since our last inspection merged with another branch and now also provided care services to people in the Lancashire and Fylde area.

During the previous inspection we found the service was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because people were placed at risk of receiving unsafe care as some care plans were lacking in detail.

During this inspection we found the service had made the necessary improvements. Staff had added more detail to care plans. The branch had introduced a review of care plans as a team, to ensure the information was clear to all readers. We discussed with the branch nurse and registered manager that aspects of people’s ‘as required’ medicines would benefit from a similar review to ensure clarity.

During the inspection we were given access to the electronic records relating to the service which included evidence of quality audits.

As part of our inspection we checked three people’s medication administration records (MAR). We found that staff had sent completed MAR for review by nurses. However, two people’s MAR we checked had not been reviewed until several months after completion. An audit had identified some outstanding records, but actions had not been completed when we inspected.

We have made a recommendation regarding the service’s keeping and auditing of records.

People and relatives we spoke with told us they overall had no concerns and had confidence in the staff providing care. A person and a relative we spoke to were concerned about arrangements, if their current staff should become unavailable. The registered manager was able to tell us about their contingency plans.

Staff we spoke with had no concerns about the service. Staff explained to us their role and responsibilities regarding safeguarding people who used the service. Staff were confident that any concerns they had would be dealt with by branch staff and the registered manager. The registered manager managed accidents and incidents appropriately.

The service had two dedicated care coordinators ensuring the safe recruitment of staff. Branch staff planned who would provide care to people months in advance, to help identify gaps. This identified vacancies which the provider was recruiting for when we inspected. The provider had effective recruitment, supervision and training processes in place to ensure the staff were safely able to support people using the service.

Care plans showed the service always sought people’s consent before providing support. Staff were knowledgeable about the Mental Capacity Act. The registered manager had written to social workers where a person using the service had transitioned from child to adult services, to ensure the appropriate authorisations were sought.

The service worked with other health professionals to provide effective care for people. We saw that professionals from hospitals had been involved in writing specific care plans for people.

Staff we spoke with talked about people who used the service in a caring way, showing understanding and knowledge of things important to people. People and relatives we spoke with told us about the caring, engaging nature of the regular staff teams.

Relatives told us they were invo

Inspection areas

Safe

Good

Updated 10 November 2018

The service was safe.

Staff were clear about their responsibilities to safeguard people and protect them from preventable risk.

People we spoke with had no concerns about the service except for some uncertainty about staffing. The service was addressing this.

Staff recruitment was robust. The service planned care for people well in advance and was recruiting additional staff to fill any gaps.

Records we viewed showed staff managed people’s medicines safely. ‘As required’ medicine instructions and processes around MAR reviews needed reconsideration.

Effective

Good

Updated 10 November 2018

The service was effective

Staff had the skills and knowledge to care for people with complex health needs effectively.

Care staff felt well supported by staff in the office. Branch staff had focused on building a good rapport with field staff.

The service worked in line with principles of the Mental Capacity Act 2005. The registered manager was working with the local authority to apply for appropriate authorisations.

Staff supported people to eat and drink well. The service was working effectively with other health professionals to plan care for people’s complex needs.

Caring

Good

Updated 10 November 2018

The service was caring.

People and relatives spoke highly about their staff teams and their caring approach.

Staff spoke warmly about people who used the service and were knowledgeable about what was important to people they cared for.

Care plans evidenced a focus on dignified approaches that respected people’s privacy and independence.

People and their relatives were involved in decisions over their care.

Responsive

Good

Updated 10 November 2018

The service was responsive.

Care plans were detailed and linked to ongoing assessments to remain up-to-date and were regularly reviewed.

The service conducted quarterly surveys and findings led to improvements.

People and relatives told us they knew how to complain. The service encouraged people to speak to any branch staff member about their concerns.

Staff were knowledgeable about people’s different communication needs and their responsibility to make information accessible.

Well-led

Requires improvement

Updated 10 November 2018

The service was not consistently well-led

Record checks to identify potential issues were at times delayed. Audits took place but did not always lead to timely corrective actions.

A registered manager was in post. The registered manager was exploring creative ways to involve staff in team meetings, to increase attendance.

People were involved in the development of the service. The service communicated consistently with people. Branch nurses met with people regularly to discuss any concerns.

Staff supported people’s diverse needs respectfully, to promote the open and inclusive culture of the service.