This inspection site visit took place on 26 September 2018 and was announced. We gave the registered manager 48 hours' notice of our visit so they could make sure they would be available to speak with us.This was the first inspection of the location since it registered with us in September 2017.
Solihull Care Limited is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older people, younger adults, people living with dementia and people with physical disabilities, sensory impairments and substance misuse problems. It operates across Solihull and Warwickshire in the West Midlands. There were 65 people using the service at the time of this inspection and 61 people were in receipt of the regulated activity personal care.
Prior to our inspection we received information of concern in relation to the service. The concerns related to some people’s care calls taking place later than scheduled and some calls being missed. Some staff had not been recruited safely, and staff did not feel supported by the registered manager. Also, the training care workers completed did not support them to carry out their roles effectively.
A requirement of the provider's registration is that they have a registered manager. There was a registered manager in post at the time of our inspection. 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 provider was heavily reliant on the registered manager to ensure the service was running effectively. Systems to monitor, assess and improve the quality and safety of the service were ineffective. The provider did not complete any audits or checks to ensure people received their care in line with the aims and values of the service. This lack of senior manager oversight meant the opportunity to drive forward improvements to benefit people may have been missed.
The provider was not consistently working within the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). However, staff worked within the principles of the Act because they asked people for their consent before providing their care.
Staff received an induction when they had started work at the service. Some people felt staff had the skills and knowledge they needed to meet their needs. However, staff had not been given sufficient support to complete all of the training they needed. The provider could not demonstrate their staff had received the training they needed to care for people effectively and safely. Checks to ensure staff worked in line with the provider’s expectations did not take place. Action was being taken to address this.
People felt safe because they received their care from staff they knew and trusted. However, the provider could not assure themselves people had received the care they had been assessed as needing. Staff described how they managed risks associated with people’s health and well-being. However, risk assessments were not always in place to support staff to keep people as safe as possible.
People spoke positively about the way their medicines were administered by the staff. However, checks to ensure medicines were managed safely completed did not take place. Action was being taken to address this.
Accidents and incidents that happened were monitored but action was not taken to reduce the risk of reoccurrence.
Enough staff were employed to meet people’s needs and overall, the provider's recruitment procedures minimised risks to people's safety. Procedures were in place to protect people from harm and staff understood their responsibilities to keep people safe.
People told us staff were caring and showed them kindness. Staff understood the importance of promoting equality and human rights as part of a caring approach.
Staff respected people’s right to privacy and upheld their dignity. People were treated with respect and were supported to retain their independence. The registered manager and staff members understood the importance of keeping people's personal information confidential.
People's needs had been assessed before they had started to receive a service. People and their relatives reviewed their care in partnership with the staff. Some people's care plans lacked detail information to support staff to provide person centred care. Further detailed information was being added to improve this.
Staff followed good hygiene practices which protected people from the risks of infection. People spoke positively about how they were assisted with the preparation of meals and drinks.
People and most relatives thought the service was well-led. The service had been through a period of instability and staff had not felt supported by their managers. Some staff felt communication between them and their managers needed to improve.
A complaint’s procedure was in place and people and their relatives felt confident any complaints that they raised would be dealt with. However, not all complaints had been resolved to the complainant’s satisfaction.
The registered manager understood the responsibilities and the requirements of their registration and were committed to improving the quality of care people received. They had identified areas which needed improving within the service and had implemented an improvement action plan to drive forward those improvements.
We found one breach 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 the report.