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Care 4 U - 466 Melton Road Requires improvement

We are carrying out a review of quality at Care 4 U - 466 Melton Road. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 13 November 2018

Care 4 U - 466 Melton Road is a domiciliary care agency providing personal care for people in their own homes. The service provides personal care for older people and younger adults. At the time of the inspection, the branch manager stated 80 people were provided with personal care from the service. This was a comprehensive inspection.

The inspection took place on 14 and 18 September. The inspection was announced because we wanted to make sure that the registered manager was available at the time of the inspection.

At our last comprehensive inspection in May 2016 we rated the service as 'Good'. On this inspection improvements were needed to ensure that people were comprehensively safe, that the service was effective, responsive and that quality assurance systems were effective in driving improvements in the service. Because of these issues, the overall rating for this inspection has reduced to 'Requires Improvement.'

A registered manager was in post. This is a condition of the registration of the service. 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 and associated Regulations about how the service is run.

We identified concerns about a number of issues. A requirement notice has been issued due to a breach of regulation in relation to the service not meeting the requirement for good governance.

Staff was not deployed in a way that would always provide people with the safe personal care they needed. Risk assessments were not always comprehensively in place to protect people from risks to their health and welfare.

Not all staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have effective choices about how they lived their lives.

Staff had largely received training to ensure they had skills and knowledge to meet people's needs, though training on a number of other relevant issues had not yet been provided and an effective check on whether staff were competent following training was not always in place.

Care plans did not always contain detailed information individual to the people using the service, to ensure that their needs were always met.

People and relatives were not always confident that concerns had been followed up. They were not always satisfied with how the service was run.

Some staff members said they had not been fully supported in their work by management.

Management had not carried out comprehensive audits to check that the service was meeting people's needs and to ensure people were provided with a quality service.

People and relatives told us that most staff were friendly, kind, positive and caring and said they had been involved in making decisions about how and what personal care was needed to meet any identified needs.

Care plans were available to people and staff, which helped to deliver a service to meet people’s care needs.

Staff recruitment checks were in place to protect people from receiving personal care from unsuitable staff.

Most people and their relatives told us that they thought staff provided safe personal care.

Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area.

People and relatives told us that medicines had been supplied so that people could take their medicine safely.

Inspection areas

Safe

Requires improvement

Updated 13 November 2018

The service was not consistently safe.

Risk assessments to protect people's health and welfare did not always contain sufficient information to protect people from risks to their health and welfare. There were not always enough staff to safely meet people’s needs. Lessons had not been comprehensively learnt from some incidents to prevent situations arising again.

Staff recruitment checks were in place to protect people from receiving personal care from unsuitable staff. People and relatives thought that staff provided safe care when they were with people. People had been assisted to take their medicines.

Effective

Requires improvement

Updated 13 November 2018

The service was not comprehensively effective.

Staff had received training to meet people's care needs, though further training, and further checks on training, were needed for staff to understand all the care needs people had. A person’s health needs had not been fully met by staff. Not all staff were aware of issues relating to mental capacity legislation and assessments.

People had received an assessment of their needs. Staff had received support to carry out their role of providing effective care to meet people's needs. People’s consent to care and treatment was sought by staff and their nutritional needs had been promoted.

Caring

Requires improvement

Updated 13 November 2018

The service was not comprehensively caring.

Systems were not always in place to deliver a caring service. People had calls that were too early or too late and staff did not have the time to stay for the agreed length of time. People’s concerns were not always being responded to.

People and relatives told us that staff were kind, friendly and caring and respected people’s rights. People’s choices had been met. Staff respected privacy and independence. People or their relatives had been involved in setting up care plans to reflect people’s needs.

Responsive

Requires improvement

Updated 13 November 2018

The service was not comprehensively responsive.

People and their relatives were not always satisfied that the service responded to needs to supply a timely service. Care plans had not comprehensively included personal information to assist in providing an individual service.

People and relatives were not always confident that concerns had been followed up, though formal complaints had been investigated and responded to.

Well-led

Requires improvement

Updated 13 November 2018

The service was not comprehensively well led.

Systems had not been comprehensively audited to identify whether a quality service had been provided. Some people and relatives told us that management did not always listen to them and put things right. Some staff told us that the management team did not provide good support to them.