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Inspection carried out on 6 March 2018

During a routine inspection

This announced inspection took place on 6 March 2018.

Panacea Care provides personal care and support to people who have mental health needs within a supported living and a domiciliary care setting. People living in a ‘supported living’ setting receive care and support, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living. This inspection we looked at people’s personal care and support people received. At the time of our inspection Panacea Care provided shared accommodation and support to 11 people living in two supported living settings one of which was the address of the registered location.

The domiciliary care service was about providing home care support to people who have mental health needs and/or learning disabilities who are living in the community. At this inspection there were two people using this particular service but none of them were receiving personal care so we did not inspect this aspect of the service.

At our last inspection carried out on the 14 November 2016 we rated the service Good. This had been a focused inspection to check on a breach of Regulation 18, which was met. The previous comprehensive inspection took place on 30 and 31 March 2016. At this inspection on 6 March 2018 we found the evidence continued to support the rating of Good.

The owner of the company was also the registered manager. 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.

The registered manager worked alongside staff on shift so that they could see how the service met people's needs.

People were happy using the service. They felt supported and were developing daily living skills to help them potentially live independently. People had been involved with planning their care and had consented to the support they received.

People’s care records included their needs and preferences. Information had been reviewed on a regular basis to help ensure people’s needs were being met. People had access to the health care services they needed and their nutritional needs were being met.

The risks to people's safety and wellbeing were assessed. People were supported to manage their own safety and remain as independent as they could be. The provider had processes in place for the recording of incidents and accidents.

Staff received training on safeguarding adults from abuse and there were policies and procedures in place to inform staff on what to do if they had a concern about a person’s welfare and safety. There had been no safeguarding incidents.

There were enough staff on duty to meet people's needs. Employment checks were in place to obtain information about new staff before they were allowed to support people. People were supported by staff who were sufficiently trained and supervised.

People were given the support they needed with medicines and there were regular audits carried out to help ensure people received their medicines.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People using the service, staff and others were asked for their feedback on the service so that the registered manager could identify what was working well and where improvements needed to be made.

There was a complaints procedure available and people told us they knew how to raise a concern or complaint.

There were checks and regular audits on a range of areas in the service to ensure people received safe good care.

Inspection carried out on 14 November 2016

During an inspection to make sure that the improvements required had been made

Panacea Care specialises in providing care to people who have mental health needs. At the time of our focused inspection Panacea Care provided shared accommodation and support to nine people living in two houses at Wood End Green Lane and Pield Heath Road. We visited Wood End Green Lane where there were six people using the service. This service is staffed seven days a week from 9am- 5pm with on-call support for people after these hours. At the second house, the Pield Heath Road service, people received support from staff twenty four hours a day and currently three people were using the service.

Panacea Care is also registered as a domiciliary care service. This provides home care support to people who have mental health needs living in the community. At this inspection there were three people using this particular service but they did not receive any support with personal care and so this was not inspected at this visit.

We carried out an unannounced comprehensive inspection of this service on 30 and 31 March 2016. A breach of a legal requirement was found as the registered and deputy manager were working seven days a week as there were not sufficient numbers of staff working to ensure they could take time off work. After the inspection, the provider wrote to us to say what they would do to meet the legal requirement in relation to the breach.

We undertook this unannounced focused inspection to check that the Provider had followed their plan and to confirm that they now met the legal requirement. This report only covers our findings in relation to the requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Panacea Care on our website at www.cqc.org.uk

There was a registered manager in post. 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 our focused inspection on 14 November 2016, we found that the provider had followed their plan of action which they had told us would be completed by 30 June 2016 and the legal requirement had been met.

The registered manager had employed two new support workers and the outreach support workers also now worked extra hours. This enabled the registered and deputy manager to have time off, usually at the weekend. Therefore we were satisfied that there were sufficient numbers of staff deployed to support people safely.

Inspection carried out on 30 March 2016

During a routine inspection

Panacea Care specialises in providing care to people who have mental health needs. At the time of our inspection Panacea Care provided shared accommodation and support to eight people living in two houses at Wood End Green Lane and Pield Health Road. We visited Wood End Green Lane where there were five people using the service and one person was in hospital. This service is staffed seven days a week from 9am-5pm with on-call support for people after these hours. We also visited on the second day of the inspection Pield Heath Road service. This is where people receive support from staff twenty four hours a day and currently two people were using the service.

Panacea Care is also registered as a domiciliary care service. This provides home care support to people who have mental health needs living in the community. At this inspection there were four people using this particular service but they did not receive any support with personal care and so this was not inspected at this visit.

Panacea Care had a registered manager in post. 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.

The inspection was carried out on 30 and 31 March 2016 and the first day was unannounced.

The service was last inspected the 9 and 10 February 2015. At that inspection we found that the provider was not meeting the legal requirements in relation to ensuring staff received ongoing training and an annual appraisal of their work, notifying the Care Quality Commission of significant events and having effective systems in place to assess and monitor the quality of service provision. At this inspection we found the provider had made improvements.

However, we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as there were not enough staff deployed to meet people’s needs safely.

There was a recruitment, induction and training process to ensure people benefitted from receiving support from suitable staff who had the skills and knowledge to meet people's needs.

The registered manager was notifying the CQC of important events and this included action taken.

The Mental Capacity Act (2005) had been appropriately applied and considered. People were involved in how they wanted to be supported and had consented to the support they received.

People’s feedback on the service and the support they received from staff was positive.

Staff respected people’s wishes, gave them choices and supported them to be as independent as possible.

People received individualised support that met their needs.

The provider had a policy and procedures for safeguarding people using the service and staff told us they had completed safeguarding adults training.

People’s support plans covered their care and needs and detailed the support they needed from staff.

Systems were in place to support people to take their medicines safely and independently where they were able to manage this task. Checks took place to make sure people safely received their medicines.

Staff supported people to attend health and medical appointments, if this support was necessary.

There was an appropriate complaints procedure in place.

The provider was active in seeking feedback from people with regard to their experiences of the service and used this to drive improvement and make alterations to how the service was run.

There were various quality assurance checks in place to ensure the service operated effectively and safely.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 9 and 10 February 2015

During a routine inspection

Panacea Care specialises in providing care to people who have mental health needs. Currently the service is staffed seven days a week from 9am-5pm with on-call support for people after these hours. At the time of our inspection Panacea Care provided shared accommodation and support to nine people living in two houses at Wood End Green Lane and Pield Health Road. We visited Wood End Green Lane at this inspection where there were six people using the service.

Panacea Care is also registered as a domiciliary care service. This provides home care support to people who have mental health needs living in the community. At this inspection there were three people using this part of the service but they did not receive any support with personal care and so this was not inspected at this visit.

The last CQC inspection was carried out 10 April 2013. At that time, we found that all regulations we assessed were met.

Panacea Care had a registered manager in post. 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.

Staff received some areas of support in their work such as having one to one supervision meetings with the registered manager, however there was no formal process for an annual appraisal and refresher training had not been arranged or completed for staff in various subjects. For example, in fire safety and safeguarding adults from abuse which was relevant to their work.

The registered manager had not reported to the Care Quality Commission notifiable incidents and events. Therefore we had not been aware of any significant events that had occurred in the past 12 months to see what had taken place and action the registered manager had taken.

We found the service to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and Mental Capacity Act 2005 (MCA) and there were no restrictions in place for people using the service.

Feedback from people about the staff was positive and people were satisfied with the level of support they received. People’s views on the service were sought on a regular basis and they were involved in the development of their care plans which were regularly reviewed. People said they felt safe living in the service and told us they were confident to raise any concerns they had with the staff and registered manager.

Systems were in place to support people to take their medicines safely and independently where they were able to manage this task. Checks took place to make sure staff recorded when they administered medicines to people. Staff supported people to attend health and medical appointments, if they agreed to this support, and ensured that people received the medical care they needed when they were unwell.

Staff encouraged and supported people to undertake a range of activities, both individually and in groups. People were encouraged to develop daily living skills such as budgeting and cooking so that they could, if they felt able to, plan their move to their own accommodation.

There were systems in place to monitor the care and welfare of people and improve the quality of the service provided.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and the (Registration) Regulations 2009 in relation to ensuring staff completed refresher training on subjects relevant to their roles and responsibilities carrying out effective audits on the service and the Care Quality Commission had not been informed of notifiable incidents and events.

You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 10 April 2013

During a routine inspection

During the inspection we spoke with two of the three people who used the service, the manager and one staff member. People told us they were happy with the care and support received. One person said "the service is excellent" and another said "I am very happy here", "I have no complaints".

We found that the care needs of people using the service had been assessed and these were reflected in their care plans.

People were protected from abuse and staff had a clear understanding of the procedure to take if there were any suspicions of abuse.

The service had thorough recruitment procedures in place to make sure that all required pre-employment checks were carried out. This meant that people using the service were cared for by suitably qualified staff.

The provider had an effective system to regularly assess and monitor the quality of the service that people received.