Background to this inspection
Updated
31 January 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
One inspector carried out this inspection.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes up to 24 hours per day. It predominantly provides a service to older people.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 8 January 2020 and ended on 17 January 2020. We visited the office location on 8, 9 and 15 January 2020.
What we did before the inspection
We reviewed information we already held about the service, including information we had received from members of the public. We sought feedback from the local authority commissioners and safeguarding team, and one social worker.
The provider completed a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with five relatives of people who use the service. We spoke with three members of staff including the registered manager and administrator. The nominated individual attended parts of the inspection. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records, including two people’s care records. We looked at two staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We emailed all 10 care workers for their feedback and to ask questions about their skills and knowledge. We received two responses. We asked four more external professionals who worked in partnership with the service for their feedback about the service. We received two responses.
Updated
31 January 2020
About the service
The service is a domiciliary care agency which provides personal care to people living in their own homes throughout Northumberland. At the time of this inspection there were 18 people using the service.
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
Shortfalls remained in the leadership and management of the service which exposed people to the risk of harm. There had been improvements made to the service, but quality checks had not been effective enough to fully identify and address concerns.
The registered manager monitored the quality and safety of the service through checks of the records. However, a comprehensive audit system was not in place. The registered manager had implemented elements of best practice into the service, however sustained improvement needed to be seen.
Relatives felt their family members were safe receiving support from staff, who knew them well. People’s care needs were assessed, and risk reduction measures were in place. However specific risks people faced were not always fully recorded. We have made a recommendation about this.
People were supported by trained staff who provided a reliable, person-centred service. Staff were kind and respectful towards people and their families and people’s privacy and dignity were upheld. People’s independence was encouraged, and they were involved in decision making.
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.
There was a good working relationship between staff, relatives and external professionals to ensure people got any extra support they needed. The service was changed as required to meet people's varying needs and wishes.
Minor incidents and complaints were recorded and acted upon to prevent a repeat occurrence. However, record keeping required improvement.
We have identified one continued breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 related to the governance of the service.
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 (report published 8 January 2019) and there were three breaches of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
The provider failed to submit an action plan after the last inspection to show what they would do and by when to improve. At this inspection, not enough improvement had been made and the provider was still in breach of one regulation.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified one continued breach in relation to the governance of the service at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from 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.