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Lancashire Rose Care Service Ltd Requires improvement

This service was previously registered at a different address - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 November 2018

The inspection visit took place on 28 September 2018 and was announced.

This inspection was the first inspection since the service was registered by the Care Quality Commission (CQC) at this location. The service was previously registered at another location.

Lancashire Rose Care Service Ltd is a domiciliary care agency. It provides personal care to people living in their own houses, flats in the community and specialist housing. It provides a service to older adults, younger disabled adults, and children. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for people supported in their own homes; this inspection looked at people’s personal care and support. At the time of the visit there were four people who used the service. Not all people who use Lancashire Rose Care Service Ltd received personal care support.

CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

During this inspection we found shortfalls in the systems and arrangements for staff training, and supervisions, there was a lack of robust governance, quality assurance processes and a failure to undertake robust recruitment checks. In addition, there was a failure to inform CQC of the change in management arrangements at the service. These were breaches of Regulation 17, Regulation 18 and, Regulation 19 of the Health and Social Care Act, 2008 (Regulated Activities) Regulations 2014 and Regulation 15 of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the registered provider to take at the back of the full version of the report.

The service had a registered manager. However, during our inspection visit we were informed that the registered manager had left the service three weeks before the inspection. The provider was in the process of finding a replacement manager. An interim manager had been appointed to oversee the running of the 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.

There were policies and procedures on how the service protected people against bullying, harassment, avoidable harm and abuse. Care staff had received training in safeguarding adults and knew how to report concerns. There were risk assessments which had been undertaken. Plans to minimise or remove risks had been recorded in line with the organisation’s policy. These covered specific risks around people’s care and specific activities they undertook in a person-centred manner.

There was a medicines policy in place and staff had been trained to safely support people with their medicines. However, medicines records had not been audited consistently. We made a recommendation about medicines management.

The recruitment processes were not robust to ensure people were protected against unsuitable staff. Records we saw and conversations with staff, showed the service had adequate care staff to ensure that people's needs were sufficiently met. In majority of the cases, staff had visited people at agreed times.

Staff had received training however, they had not received regular supervision in line with the organisation’s policy. Spot checks were not undertaken to observe and check staff’s competence

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, knowledge and application of the mental capacity principles required further improvements.

Care plans were in place detailing how people wished to be supported however, people’s care was not regula

Inspection areas

Safe

Requires improvement

Updated 6 November 2018

This service was not always safe.

Staff had not been safely recruited to protect vulnerable adults and children from inappropriate staff.

People’s medicines had not been safely managed. Staff had been trained and their competence tested for safe administration of medicines.

Staff had received safeguarding training and knew how to report concerns.

Risks to the health, safety and well-being of people who used the service were assessed and plans to minimise the risk had been put in place.

Effective

Requires improvement

Updated 6 November 2018

This service was not always effective.

Staff had received training and induction. However, supervision and spot checks had not been provided to monitor staff's performance.

There was a policy on seeking consent and staff had received training in mental capacity.

People were adequately supported with their nutritional needs. However, improvements were required to ensure consistency with the staff who supported people with meals.

Caring

Good

Updated 6 November 2018

The service was caring.

Staff treated people treated in a kind and caring manner.

People's personal information was managed in a way that protected their privacy and dignity.

Staff knew people they supported well, and they spoke respectfully about them. The service supported people to express their views and to make choices.

Responsive

Requires improvement

Updated 6 November 2018

The service was not always responsive.

People had a plan of care which included essential details about their needs. They had been written in a person-centred manner. However, people's care was not always reviewed.

There was a complaints policy. However feedback from people showed they were not aware of how to raise concerns about their care and treatment.

Well-led

Requires improvement

Updated 6 November 2018

The service was not consistently well led.

The registered manager was no longer employed by the service.

Policies for assessing and monitoring the quality of the service were in place. However, the systems and processes had not identified areas where improvements were required. Management had not provided adequate oversight on the service.

We found shortfalls relating to medicines management, staff training and supervision and audit systems in the service.

Improvements were required to promote joined up working with other agencies.

Staff's and people's views were sought.