Bognor Regis

Olut Care is a is a domiciliary care agency which provides support for adults in the community, including those living with dementia. At the time of the inspection 15 people were receiving personal care services supported by seven care staff.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Systems in place to assess and monitor the quality of the service were not sufficiently robust to identify that improvements were needed in relation to staff recruitment and person-centred support plans.

Risk assessments did not always provide sufficient details, so staff could support people safely. People told us they felt safe using the service. Accidents and incidents were recorded and acted upon. People received their medicines safely. Staff followed infection control procedures.

People were supported by trained staff. Assessments were carried out prior to people joining the service to ensure their needs could be met. People were supported to maintain good health and had access to a range of health and social care service’s.

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

People were supported by caring and compassionate staff who provided dignified care and respected people’s privacy. Staff knew people well which ensured they provided support in line with their wishes. People were involved in the planning and review of their care.

Staff spoke positively about working for the provider and felt well supported. Staff were able to raise ideas for service improvement and these were listened to. There were procedures in place to respond to complaints. The provider had investigated and responded promptly to any concerns received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 5 February 2019) and there were three breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough, improvement had not been made and the provider was still in breach of two regulations. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to governance and the safe recruitment of staff at this inspection. Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Not everyone using Bognor Regis received a regulated activity. The organisation also provided a companionship service and support with domestic chores. CQC only inspects the service 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. At the time of inspection, the service provided personal care and support to two people.

There were two registered managers 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. The registered managers also owned the company Olut Services Ltd, which was the registered provider.

This was the first inspection of Bognor Regis since registration. This inspection took place on 10 and 11 December 2018. It was an announced visit, which meant the service was given 48 hours’ notice, to ensure staff were available to facilitate the inspection. Bognor Regis had only recently started to provide a service and therefore they could only be assessed on the small provision supplied at the time of the inspection.

The service was not safe or effective in all areas. The provider could not be assured that staff working for the DCA were suitable and safe to undertake their designated duties. The recruitment practice followed did not comply with the service’s procedure. It did not ensure two references from appropriate sources were secured or that a full employment history was used to confirm staffs background.

Staff were involved in ‘prompting’ people with their medicines. Records relating to what this support included was not clear. For example, there was no record of what medicines people were taking or a procedure to support staff in this role.

The provider could not be assured that the staff deployed were suitably trained to undertake their roles competently and safely in accordance with their procedures. Staff only completed a one-day training day before working for the DCA. This did not include all key areas, for example training on the Mental Capacity Act (MCA) or on medicines. The provider could not be assured that consent to care was sought in line with legislation and guidance. There was no record that people had been consulted on their care and support or that they had consented to the package of care supplied.

The service was not well-led. Management systems had not ensured the service’s policies and procedures had been followed. There was no operational framework to ensure the quality of the service. Quality monitoring systems including auditing and checking and monitoring quality had not been fully established to ensure safe and effective care.

People told us they liked the staff that visited them and had regular staff attending to them. They liked the consistency offered by the service and the registered managers often covered visits when regular staff were not available. The staff arrived on time and stayed for their allocated period. People told us staff completed the tasks required of them along with any additional requests. Staff were flexible and accommodating.

People were supported by staff who demonstrated kindness and had a caring approach. Staff knew people well and supported their independence as far as possible. A relative told us they had good communication with the care staff and the registered managers. Staff had a good understanding of safeguarding procedures and knew what actions to take if they believed people were at risk of abuse. As part of the assessment process, risk assessments were carried out in relation to people’s homes, their individual needs and where necessary, actions were taken to mitigate risks to reduce the risk of accidents or injuries.

Care plans were used to document the care package that was tailored to people’s needs. Daily records were completed and supported effective communication between staff, and people’s representatives. Staff felt well supported and had close contact with the registered managers who had good oversight of the people’s individual needs. Staff recognised any changing needs and responded quickly working with, relatives, health and social care professionals as necessary.

Spot checks were used to monitor staff performance and the standard of care. Staff felt well supported and valued as an employee. They told us the registered managers cared about them as well as the people they look after.

This is the first time the service has been rated Requires Improvement. We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.