Archived: Care Support Force Limited

Updated 16 March 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the registered provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 27 October, 7 and 14 November 2016 and was announced. The registered provider was given 48 hours’ notice of our visit, because the location provides a domiciliary care service and we needed to be sure that someone would be in the location offices when we visited.

The inspection was carried out by one Adult Social Care Inspector and an Expert by Experience. An Expert by Experience is someone who has personal experience of using or caring for someone who uses this type of service. The Expert by Experience supported our inspection by making telephone calls to people who used the service and their relatives to ask their views about the service provided by Care Support Force Limited.

We did not ask the registered provider to complete a provider information return (PIR) before this inspection. This is a form that asks the registered provider to give some key information about the service, what the service does well and what improvements they plan to make.

When planning our inspection, we looked at information we held about the service, which included information shared with the Care Quality Commission (CQC) via our public website and notifications sent to us since our last inspection of the service. Notifications are when registered providers send us information about certain changes, events or incidents that occur within the service. We also contacted the local authority’s adult safeguarding and commissioning teams to ask if they had any relevant information about the service. We used this information to plan our inspection.

Before our visit, we received information raising concerns about the service provided by Care Support Force Limited. This included concerns regarding staffing levels and the management of medicines. We have recorded our findings in relation to these and other concerns in the body of this report.

As part of this inspection, we visited two people who used the service and spoke with seven other people by telephone. We also spoke with four people who were the relatives or carers of people who used the service. We visited the location offices and spoke with the registered manager, deputy manager and three members of staff. We looked at four people’s care files, five staff recruitment and training files, medication administration records, meeting minutes and a selection of records used to monitor the quality of the service.

Updated 16 March 2017

Care Support Force Limited is a small domiciliary care agency. The service is based in Pocklington and is registered to provide personal care to people living in their own homes.

We inspected this service on 27 October, 7 and 14 November 2016. The inspection was announced. The registered provider was given 48 hours’ notice of our visit because the location provides a domiciliary care service and we needed to be sure that someone would be in the location’s office when we visited.

At the time of our inspection, the service was supporting 17 people with the regulated activity ‘personal care’.

We rated the service ‘Good’ when we last inspected in October 2015.

The registered provider is required to have a registered manager as a condition of registration for this 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 2008 and associated Regulations about how the service is run. At the time of our inspection, the service did have a registered manager who was also the nominated individual.

During our inspection, we identified concerns about late and missed visits from staff. We found evidence that staff did not consistently stay for the agreed length of time at each visit due to staff shortages. People we spoke with told us there had been a high turnover of staff and raised concerns about the skills, knowledge and experience of some of the staff employed.

We identified gaps in staff’s training and supervisions had not consistently been completed to monitor and support staff’s continued professional development.

Appropriate records were not always maintained of the care and support provided for people to take prescribed medicines. The registered provider did not have a sufficiently detailed or up-to-date policy and procedure to guide staff on how to safely administer medicines.

Although we received a number of positive comments about the care and support provided by Care Support Force Limited, some people we spoke with raised concerns about a disorganised service, a lack of communication and that the registered manager was not always responsive to issues or complaints.

There was not a robust system of quality assurance audits in place to monitor and improve the quality of the service provided. Issues and concerns identified during the course of our inspection had not been robustly addressed. The registered provider had failed to display their rating following the last Care Quality Commission inspection on their website.

We found breaches of regulation in relation to staffing levels, safe care and treatment, the requirement to display ratings and good governance. You can see what action we told the registered provider to take at the back of the full version of this report.

People who used the service were asked to consent to the care and support provided. Where there were concerns regarding one person's mental capacity, we found clear and complete records were not in place with regards to decisions about their care and support. We have made a recommendation about this in the body of our report.

People who used the service had developed positive caring relationships with some of the regular staff that supported them. However, people told us that a number of staff had left and there had been a high turnover of new staff which sometimes impacted on the quality of the care and support they received.

Person centred care plans were put in place to support staff to meet people’s needs. However, people we spoke with told us they had to prompt and remind some staff who did not appear to know what they were doing. This was not good person centre care. We have made a recommendation about this in the body of our report.

There was not a robust and transparent system in place to evidence how the registered provider listened and responded to feedback about the service provided. We have made a recommendation about the management of complaints in the body of our report.

People’s needs were assessed and proportionate risk assessments put in place to guide staff on how to provide safe care and support. People who used the service told us they felt safe with the care and support that staff provided.

People who used the service were supported, where necessary, to prepare meals and drinks and to access healthcare services if needed.

People provided positive feedback about individual members of staff and told us they treated them with dignity and respect and supported them to make decisions about the care and support they received.

During the inspection, we identified that the registered manager had sold a number of personal items to someone who used the service. This was a clear conflict of interest. We are carrying out further enquiries in relation to this and will report on our findings at a later date.