Archived: Quality Home Care

Updated 10 March 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is 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.

This inspection took place on 24 and 25 January 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would available in the office. The inspection was carried out by one inspector and an expert-by-experience. An expert-by-experience is a person who has through personal experience or by a relative, received personal care.

Before our inspection we looked at information we held about the service including notifications. A notification is information about important events which the provider is required to tell us about by law. We also received feedback about the service from representatives of the local authority’s contracts monitoring team; this helped with our inspection planning.

During the inspection we spoke with seven people who used the service and four relatives. We spoke with the registered manager, policy assurance manager, the deputy manager, one senior care co-ordinator, two team leaders and two care staff.

We looked at four people’s care records, three staff recruitment files, quality assurance surveys, staff meeting minutes and medication administration records and audits. We checked records in relation to the management of the service such as staff training records.

Updated 10 March 2017

Quality Home Care is registered to provide personal care to people living in their own homes. At the time of our inspection a service was being provided to older people, people living with dementia, people with a physical disability, younger adults and people with a learning disability or autistic spectrum disorder. There were 105 people receiving personal care from the service and there were 28 care staff employed.

We inspected this service on 24 and 25 January 2017. The inspection was announced.

At the last inspection on 8 and 11 July 2016 there was a breach of the legal requirements found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

Improvements were needed to ensure that people were protected through the assessment and safe management of risks. People were not protected because staff had not followed the provider’s policy and procedures in relation to the management and recording of their prescribed medication.

During this inspection we found that the provider had made some improvements in relation to the previous breach.

There was an increased risk that people may not receive their prescribed medication. The provider’s policy on administration and recording of medication had not been followed by staff. Audits in relation to medication administration record (MAR) charts had been completed but were not robust, as they did not always identify all areas of improvement required.

There were some systems in place to monitor and audit the quality of the service provided. However, there were no audits on most areas of risk within the service. This meant that the provider’s quality monitoring system was not always robust or thorough enough to monitor and drive forward the necessary improvements needed.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 scheme is run.

People had their needs assessed and reviewed so that staff knew how to support them to maintain their independence. People’s care plans contained person centred information. The information was up to date and correct. People’s privacy and dignity was respected by staff and staff treated them with kindness.

People had risk assessments completed and staff had the necessary information they needed to reduce people’s risks.

There was a system in place to record complaints. This included the outcomes of complaints and how the information was used to reduce the risk of recurrence.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and could describe how people were supported to make decisions. Training had been provided by the service and staff were aware of current information and regulations regarding people’s care. This meant that there was a reduced risk that any decisions made on people's behalf by staff would not be in their best interest and as least restrictive as possible.

The risk of harm for people was reduced because staff knew how to recognise and report abuse. Staff had completed all training required by the provider. There was a system to ensure that staff received further training to update their skills.

The provider’s recruitment process was followed and this meant that people using the service received care from suitable staff. There was a sufficient number of staff to meet the needs of people receiving a service.

Staff meetings, supervision and individual staff appraisals were completed regularly. Staff were supported by team leaders, two care co-ordinators, deputy manager and the registered manager during the day. An out of hours on call system was in place to support staff, when required.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.