8 May 2018
During a routine inspection
The service had a registered manager 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 manager was not present for this inspection and therefore we were unable to check whether they continued to meet the requirements of their role including demonstrating the necessary competence and experience to manage the regulated activity.
At this inspection we found only one person was using the service. Support for this person was due to end in the days following our inspection. Although plans for the service after this date were unclear, the director of Homes Association was looking at ways the service could become fully operational again in the future.
Due to the changes at the service senior staff roles and responsibilities had changed. The director was managing the service on a daily basis with the registered manager only carrying out specific duties when required. The director lacked experience and knowledge of managing services as we found aspects of the service were not as well managed as they should be. Recruitment checks carried out by the director had not been sufficiently robust to ensure staff were suitable to work. The director was not aware of current best practice in relation to medicines to ensure these were managed appropriately and safely. The director also did not fully understand their responsibility to ensure legal requirements were met at all times. The director acknowledged our concerns and told us they would be reviewing management arrangements after our inspection to address these.
The director acted to put things right when needed. Improvements had been made at the service in response to external concerns raised about the quality of service. This included improvements to people’s care records, the frequency of staff supervision meetings, implementation of policies and procedures and improved access for people to the out of hours on call system. We will check at the next inspection of the service if these improvements have been maintained and sustained.
The person using the service received the support that had been planned and agreed with them. The person’s choices for how this was provided were respected and staff delivered support in line with the person’s wishes. Staff had access to current information about the level of support the person required along with guidance on how to keep the person safe from identified risks. Staff encouraged the person to carry out tasks of daily living to help them maintain the skills they needed to live independently in the community. Staff recorded the meals provided to the person so that all involved in the person’s care could monitor they were eating and drinking enough to meet their needs. Staff reported any concerns about the person so that appropriate support could be obtained from the relevant healthcare services. The person was supported by staff they were familiar with which helped to ensure continuity and consistency in their support.
The person using the service had capacity to consent to specific decisions about their care and support needs. Staff received training in the Mental Capacity Act (MCA) 2005 so that were made aware of their responsibilities under this Act.
Staff received training to safeguard people from abuse. They also received training specific to their role to help them to meet people’s needs. Staff followed good practice to ensure risks were minimised from poor hygiene and cleanliness when providing personal care and when preparing and handling food. The director met with staff monthly to monitor their working practices and to identify opportunities for further learning and development.
The director asked people for feedback about the quality of the service and suggestions for how this could be improved. If people were unhappy and wished to make a complaint there were arrangements in place to deal with this.
As the service was only supporting one person at the time of this inspection we were unable to obtain sufficient evidence to rate the service at this time. We did however find the provider in breach of legal requirements with regard to fit and proper persons employed and good governance. You can see what action we told the provider to take at the back of the full version of the report.