Archived: Grace Home Care Services

Updated 22 September 2016

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.

The inspection of Grace Home Care took place on 28 July 2016 and was an announced inspection. We told the registered manager two days before our visit that we would be coming. We did this because they were sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure they would be available.

Before our inspection we reviewed the information we held about the service. We contacted the local authority to obtain their views about the care provided. We considered the information which had been shared with us by the local authority and other people. We looked at notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

During our inspection we went to the office and spoke to the registered manager, and care co-ordinator. We also spoke with three staff members. We reviewed the care records of four people that used the service.

We looked at three staff recruitment files, supervision and training records, and spoke with the registered manager about the systems in place for monitoring the quality of care people received. We looked at a variety of the service’s policies such as those relating to safeguarding, medicines, complaints and quality assurance.

The registered manager told us not everybody who used the service was able to speak with us on the telephone. Therefore following the inspection visit we undertook phone calls to the relatives of two people that used the service to get their feedback about what it was like to receive care from the staff. We also spoke with two health and social care professionals to get their views on the service.

Updated 22 September 2016

We carried out an inspection of Grace Home Care Services on 29 May and 2 June 2015 where we found the provider had not met the regulations in relation to the safe management of medicines, the provider did not have an effective system to regularly assess, monitor and improve the quality of service that people received and the provider had not fulfilled their statutory obligations to the CQC with regard to notifications and was not notifying the Care Quality Commission of incidents that affected people.

An action plan was submitted by the provider that detailed how they would meet the legal requirements by 9 October 2015.

We undertook an announced inspection on 28 July 2016 to check the provider had made improvements and to confirm that legal requirements had been met. At this inspection we found improvements had been made in relation to notifications. However, improvements were still required in relation to medicines and assessing and monitoring the quality of service that people received. We also found improvements were required in other areas.

We told the provider two days before our visit that we would be coming. We did this because they were sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure that they would be available.

Grace Home Care is a domiciliary care agency that provides care and support services to people in their own homes. At the time of our inspection 17 people were using the service. Some people who used the service lived reasonably independent lives but required support to maintain this independence. Other people required more support due to their long term healthcare needs such as diabetes or the risk of falls. Some people were living with dementia type illnesses.

There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law. The registered manager was also the owner of the service.

At this inspection we found care plans where information did not reflect people’s current support needs and other care plans did not include the level of detail staff may require to provide people with the appropriate level of support. There were no systems to assess the quality of the service provided and the registered manager had not identified the shortfalls we found.

People told us staff were kind and caring and supported them in the way they chose. Staff knew people well as individuals and had a good understanding of people’s care and support needs. There was information about people’s mental capacity in their care plans but we found when people lacked capacity it was not clear how consent was sought or how decisions were made in their best interest.

Medicines were managed safely however there was no clear guidance about how staff should apply topical creams to people who required them. Staff had not received regular supervision or spot checks to ensure they were supporting people properly.

There were enough staff who had been appropriately recruited to look after people who used the service. The registered manager undertook an assessment before people started using the service to ensure there were enough staff to support them appropriately.

Some people required support from staff to have enough to eat and drink and maintain a healthy diet. This was recorded in their care plans and staff had a good understanding of the support people needed.

People told us the registered manager was approachable and they were able to discuss any concerns or worries with her.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.