Archived: Complete Community Health Care Ltd

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.

Risks had not always been identified and planned for. Staff did not have enough information about how to support people who, due to their needs, displayed behaviour which could be challenging to staff. Medicines were not always safely managed. Staff did not always have information about the medicines they were administering, and records did not always show people received their medicines as prescribed.

People’s rights had not always been upheld as the Mental Capacity Act 2005 had not been adhered to. Records showed that staff had not always respected people’s decisions about their care, despite not assessing their capacity.

Records were not complete. People’s needs had changed dramatically but their records had not been updated to reflect this. Monitoring arrangements in place to reduce the risk of financial abuse were not effective. Staff recruitment checks did not show safe processes had always been followed.

Checks the registered manager undertook were not robust enough to ensure that service was performing well and following processes. Accident and incidents were not reflected on to drive improvements.

People told us they felt safe and well cared for. They told us staff were conscientious, kind and reliable. Staff arrived when people expected them to, and stayed for the full duration of their visit. Staff afforded people respect and dignity and delivered care and support with compassion.

Staff had been proactive in sourcing new opportunities for people to participate in activities. Staff knew people well and understood their care needs. People told us they thought the service was well managed.

We identified three breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 around safe care, the need for consent and governance. Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection: This is the first inspection of this service since it registered in October 2017.

About the service: Complete Community Health Care Ltd is a domiciliary care agency. At the time of our inspection 15 people, living in their own homes, were receiving personal care from the service. Care was provided to older people and people with physical health needs.

Why we inspected: This was a planned inspection.

Follow up: We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good.