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Archived: Plymouth Support Service Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 27 July 2018

Plymouth Support Service is a domiciliary care service registered to provide personal care. The service provides personal care and support to adults of all ages living in their own homes within the Plymouth area. It provides a service to people with a learning disability who may also have a physical disability and people living with sensory impairment.

Plymouth Support Services also provides care and support to people living in a 'supported living' setting. Where people live in their own home and receive care and/or support in order to promote their independence. If there is genuine separation between the care and the accommodation, the care they receive is regulated by CQC, but the accommodation is not. The support that people receive is often continuous and tailored to their individual needs. It aims to enable the person to be as autonomous and independent as possible, and usually involves social support rather than medical care.

The service supports some people on a 24 hour basis and others who may require support with personal care needs at specific times of the day and/or night. At the time of this inspection, seventeen people received support with their personal care needs from the agency including people in the shared houses.

The service 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.

At the last inspection in April 2016 the service was rated Good. At this inspection we found the service Required Improvement.

Why the service is rated Requires Improvement.

We visited and spoke to 15 people in their own homes and observed the interaction between them and the staff supporting them. People were not all able to fully verbalise their views, so staff used other methods of communication, for example visual choices and sign language.

The service was not consistently safe. When asked, people from one shared house said they did not feel safe. They raised concerns about a person who lived nearby. This person and the people living in the shared house had to gain access to their front door via the shared car park/garden area. People did not feel safe leaving their own home, some people missed appointments if the person concerned was outside of their home as they felt too frightened to leave. Staff also felt intimidated either going off duty or if they were leaving with people they were supporting to access the community if this person was outside in the shared car park/garden area. The service manager was currently in talks with the local safeguarding team over this issue.

People and relatives also raised concerns over a second provider currently providing overnight care for people in one of the shared houses. They were not happy with the level of care and one person commented; “Not sure if they are going to turn up.” The provider was due to stop providing care shortly.

Staff highlighted an issue with one person and their current funding level to help keep them safe and well cared for. This person’s care records all clearly showed they required two to one staffing to assist them to the toilet. At times this person was in the shared house with only one member of staff. Staff told us of an occasion that this person had to wait 45 minutes to be taken to the toilet. This could have caused this person a lot of discomfort and the Commission reported this to the local safeguarding team. The service manager overseeing this service said they were in the process of trying to obtain additional money to fund extra hours to support this person whose health had deteriorated over time due to increasing age. However records showed this person had been receiving over 700 minutes of additional care hours currently pro

Inspection areas

Safe

Requires improvement

Updated 27 July 2018

The service was not always safe.

There was not always sufficient staff on duty to meet people's needs safely.

Though staff did their best to keep people safe, people in one shared house felt unsafe leaving their own home due to concerns over a neighbour�s behaviour.

People had risk assessments in place to mitigate risks associated with their individual needs.

Staff were recruited safely.

People received their medicines in a safe way.

Staff followed safe infection control procedures.

Effective

Good

Updated 27 July 2018

The service remains Good.

Caring

Good

Updated 27 July 2018

The service remains Good.

Responsive

Good

Updated 27 July 2018

The service remains Good.

Well-led

Requires improvement

Updated 27 July 2018

The service was not always well led.

Checks and audits had not highlighted all areas for improvement identified during this inspection.

The management team did not all provide supportive approachable leadership.

People's feedback about the service was sought and their views were valued and acted upon.

Staff were motivated and inspired to develop and provide quality care.