Background to this inspection
Updated
14 September 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the registered manager would be in the office to support the inspection.
Inspection activity started and ended on 28 August 2019. We visited the office location on 28 August 2019.
What we did before the inspection
We reviewed information we had received about the service since their registration. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with three members of staff including the registered manager, recruitment manager and a care worker. We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two people who used the service and two relatives of other people to seek their views of the service.
Updated
14 September 2019
Regus House – Office No 206 provides a domiciliary care service for older people living in their own homes in the community. At the time of our inspection, there were seven people receiving personal care.
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
Not all risks to people’s health and safety had been identified and assessed. Risk assessments did not always contain guidelines for staff about how to reduce risk and support people to remain safe. There was no evidence that people’s needs were assessed before they started using the service.
People’s records did not always contain the correct or necessary information and there was a risk staff would not know how to meet people’s individual needs. Where there were care guidelines, these were sometimes basic and lacked detail.
People were not always supported to have maximum choice and control of their lives and staff did not support 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.
Where a person lacked the mental capacity to make a decision, the provider did not always make sure others making decisions for them had the legal authority to do so.
The provider carried out a range of checks and audits to monitor the quality of the service and make improvements where needed. However, these had not always been effective and had failed to identify some of the areas for improvement we found.
People who used the service and their relatives were happy with the service they received. People said the staff were kind, caring and respectful and they had developed good relationships with them.
The provider worked with other professionals to help make sure people had access to health care services. People received their medicines safely and as prescribed. People’s nutritional needs were assessed and met.
Staff were happy and felt well supported. They enjoyed their work and spoke positively about the people they cared for. They received the training, support and information they needed to provide effective care. The provider had robust procedures for recruiting and inducting staff to help ensure only suitable staff were employed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 9/8/2018 and this is the first inspection.
Why we inspected
This was a planned inspection based on the date the service registered.
We have found evidence that the provider needs to make improvement.
Enforcement
We have identified breaches in relation to safe care and treatment, person-centred care, need for consent and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.