Archived: Care Support Force Limited

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.

We saw that care needs were discussed with people and/or their relatives and before people received care their consent was asked for. One person said 'I am very happy with my care; they always ask me what I need help with'.

People told us they were well cared for. One person said 'I am happy with the care I receive'. Another person told us 'The staff are very good, they'll do anything you ask them to'.

There were effective recruitment procedures in place which ensured staff were employed with the appropriate qualifications, skills and experience necessary for them to carry out their role. Staff had received appropriate professional development and training to ensure they could meet the needs of the people who used the service.

The provider had systems in place to assess and monitor the quality of service that people received. Records were found to be accurate, detailed and regularly reviewed.

People who used the service told us that they were happy with the care and support they received. They told us that the care workers provided the care they needed, that they protected their privacy and dignity and that they felt safe whilst they were in their home. People told us "You couldn't get any better" and "Their help is very good".

The provider had systems in place to assess and monitor the quality of service that people received. Medicines were safely administered.

People who used the service were at potential risk of receiving care from people who were not of good character as appropriate reference checks had not been undertaken before staff began work.