FCNA Homecare

FCNA Homecare is a domiciliary care agency providing personal care to 2 people. The service provided support to older and younger adults. At the time of our inspection there were 16 people using the service in total.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People’s experience of using this service and what we found

People and relatives felt care was provided safely. However, people’s risk assessments required development to ensure staff were provided with detailed guidance on how to manage risks associated with the provision of people’s care. Recruitment checks had not always been carried out; at the time of inspection the registered manager had begun to address this however, people’s references had not been obtained and recruitment records were not always present in staffs files. The administration of people’s medication was carried out safely; however, we identified in some instances people’s medication records had not been completed correctly. The registered manager provided evidence staff had completed refresher training relating to the management and administration of people’s medicines. We have made a recommendation the provider reviews people’s risk assessments.

Staff’s training and induction programme had been reviewed by the registered manager however, there were gaps in staffs training. People’s dietary needs and preferences were recorded in their care plans; however, where some people required a ‘soft’ diet the consistencies of their food and fluids had not been recorded. The registered manager was following this up at this time of inspection and had requested a referral with the appropriate professionals. Initial assessments carried out for people required further development to capture people’s needs in detail. The provider used an electronic care planning system which required additional detail in some cases to provide staff who did not know people well with clear guidance on how they wished to be supported. We have made a recommendation the provider ensures communication with external professionals is documented.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

Relatives praised staff for the care provided to people and stated people were supported by staff who understand their needs well. Staff feedback demonstrated they knew how to support people while protecting their dignity and privacy and promoting their independence. Staff understood how to provide person centred care.

Some relatives raised concerns regarding the timings of calls, stating calls were often late. Relatives reported this didn’t impact areas of care such as the administration of medicines; they stated they felt better consistency in the times could be achieved with better organisation from the management team. Relative feedback around the response to complaints was mixed; for example, one relative told us they felt the registered manager was responsive to concerns raised, while another relative told us the opposite. People’s communication needs were not always clearly recorded in their care plans. We have made recommendations the provider reviews complaints management and their oversight of care planning.

The providers governance systems required significant development. We were unable to evidence any provider oversight of the registered managers operational management of the service. This meant any gaps in auditing, oversight and governance at registered manager level had not been identified or supported by the provider. We found the providers electronic care planning system produced compliance percentages; in several areas compliance was low. We discussed this with the provider who shared an audit template they intended to complete to improve oversight of the service. By the end of our inspection there was no evidence to show this had been completed and additional governance systems at provider level were needed to identify, assess and improve areas of the service. We have made a recommendation the provider reviews their governance systems to ensure the registered manager solely focuses on the management of the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 9 October 2019)

Why we inspected

This inspection was prompted by a review of the information we held about this service. Additionally, the inspection was prompted in part due to concerns received about the management of the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of the full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to staffing and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

FCNA Homecare is a 24-hour service, seven days a week, including night sittings. The agency operates from a private dwelling in the Bromley Cross area of Bolton. At the time of the inspection there were 18 people receiving care and support.

People’s experience of using this service:

The service was good in placing people at the heart of the service values. It had a strong a local community-based ethos. The provider who is also the registered manager was committed to providing good quality, person-centred care to people when they needed it. People who used the service and their relatives were complimentary about the care, kindness and reliability of the staff.

People’s needs, preferences and wish were met by a dedicated staff team who knew the people they cared for well. This was done through initial meetings and regular reviews.

Staff were safely recruited, well trained in both essential and specialist training as required. Staff had undertaken safeguarding training and were aware of how to report any concerns of abuse and were confident these would be dealt with. Staff felt supported by the registered manager.

People were safely supported, and risk assessments about their care and support was assessed, met and reviewed. Some people were supported with their medication. Audits and checks were in place to show that medicines had been administered safely and as prescribed.

People confirmed that staff treated them with respect for their dignity and privacy. The open, inclusive and supportive nature of the service meant that promoting equality and diversity and respecting people’s human rights was embedded throughout the service.

People’s care and support plans were detailed and were followed in practice.

The registered manager was dedicated to providing support and care to a high standard.

Rating at last inspection:

FCNA Homecare is an established company, the registered manager had worked with the service under the previous provider. This was the first inspection since the new registration and move to new premises. The service was registered in July 2018.

Why we inspected:

This was a planned inspection.

Follow up:

We will continue to monitor information we receive about the service until we return as part of our inspection programme. If we receive any concerning information we may inspect sooner.