Archived: 339 Seaside Road

339 Seaside Road is a domiciliary care agency and provides personal care to some people living in their own homes. At the time of this inspection there were 10 people receiving a service. Not everyone using the service received the regulated activity of personal care; CQC only inspects the service being 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.

The service did not have a manager who had registered with the CQC. There was an acting manager (who was also the nominated individual) present during the inspection who had begun the process of registering with the CQC. A registered manager is a person who has registered with the 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.

There was a failure to ensure records reflected potential risks identified elsewhere in people's care plans. Documented risk assessments were not in place for identified risks such as moving and handling, pressure care, catheter care and epilepsy. This placed people at risk of otherwise avoidable harm.

There was a failure to protect people against the risks associated with the unsafe management of medicines by the inappropriate arrangements for recording and administration of medicines used. The records in relation to the administration of people's medicines were not clear and there was no record that these had been monitored by a manager. Staff who were administering medicines to people in their own homes and had not received appropriate training to do so. This posed a risk to people.

Staff did not receive induction and regular supervision to discuss work performance, practice and development. There was no evidence that staff had received appropriate training to enable them to safely and effectively carry out their job roles and duties. For example, moving and handling people. This meant people’s health, safety and well-being was at potential risk of harm.

People told us they felt safe receiving a service from the staff and that they would tell someone if they were worried about anything. Staff we spoke with were able to demonstrate they knew the different types of abuse. However, we were unable to see any evidence that staff had received training in this subject during their employment with the service. The manager did not demonstrate to us that they understood their regulatory responsibilities for operating the service, and had failed to inform the CQC of a safeguarding concern.

The manager and staff were unable to demonstrate they had received any training or understood the principles of the Mental Capacity Act (2005), Deprivation of Liberty Safeguards (DoLS) and the Court of Protection. The legal requirements of the Mental Capacity Act (2005) had not been followed.

Sufficient detail had not been incorporated into care records to ensure safe care was provided. People were supported with eating and drinking but specific risks relating to eating and drinking had not been recorded in one person’s care records. Care plans were in place, but these were basic in design and lacking in individual detail, and in some cases, were not person-centred.

People were not provided with information on how to complain if they were unhappy with the service. There was no evidence that feedback had been obtained from people, relatives, staff or healthcare professionals about the quality of the service.

The service was not well-led. The leadership and management of the service was inadequate and placed people at risk of harm. There were no effective systems in place to assess, monitor and improve the quality and safety of the service provided in the carrying out of the regulated activity. There was a failure to maintain accurate up to date records to mitigate associated risks for people. The lack of systems in place meant the manager had failed to identify and address the lack of individual details in people’s records, staff induction, training and supervision, knowledge of the MCA and DoLS, management of risks to people, information on how to complain, and notifications which are required by law.

People told us, and we observed that staff were kind and caring. People’s privacy and dignity was maintained. People were supported to access healthcare services when they needed to, including their GP and dieticians.

Appropriate checks were completed to determine whether staff were suitable to work with vulnerable people. Suitable numbers of staff were employed to ensure calls could be completed in a timely manner.

We found seven breaches of regulations in relation to person-centred care, need for consent, safe care and treatment, safeguarding service users from abuse and improper treatment, receiving and acting on complaints, good governance and staffing. Full information about CQC's regulatory responses to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is inadequate and the service is therefore in 'special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.