This service is a domiciliary care agency (DCA). It provides personal care to people living in their own home. It provides a service to older people. 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.