Background to this inspection
Updated
31 August 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
Two inspectors visited the office to carry out the inspection. After the inspection visit one inspector made telephone calls to staff and people who used the service to gain their feedback.
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 did not have a manager registered with the Care Quality Commission. The registered person told us they were currently in the process of recruiting one.
Notice of inspection
This inspection was announced.
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 a member of the management team would be in the office to support the inspection.
Inspection activity started on 11 July 2019 and ended on 16 July 2019. We visited the office location on 11 July 2019.
What we did before the inspection
Before the inspection we reviewed information we had received about the service since registration. This included looking at information held upon our database about the service for example, statutory notifications completed by the registered provider. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We sought feedback from the local authority safeguarding and contracts and commissioning teams. This information helps support our inspections. We used all this information to plan our inspection.
During the inspection
We spoke with six people who used the service. We spoke with the registered person, the care coordinator, the senior supervisor and three members of staff responsible for providing care in people’s homes. To gather information, we looked at a variety of records. This included care records related to three people who used the service and information related to the management of the service. This included three staff files, the business continuity plan and policies and procedures. We did this to ensure the management team had oversight of the service and to ensure the service could be appropriately managed. In addition, we visited one person in their home to review records maintained by staff.
After the inspection
We continued to communicate with the provider to verify our findings. We looked at further information emailed to us in response to the feedback provided during the inspection visit.
Updated
31 August 2019
About the service
Coastal Home Care Services is a domiciliary care agency providing personal care to people living in their own homes within Lancaster and Morecambe and surrounding areas. At the time of the inspection 14 people were receiving a service.
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
Although people told us they felt safe, we found staff practice did not always promote safety. People’s medicines were not consistently managed in a safe way. Deployment of staff was not always effective to ensure visits took place as scheduled. Staff recruitment checks were not always carried out in a timely manner. People’s individual risk was not always effectively addressed and managed.
The service was not always well-led. Oversight of the service was inconsistent and identified concerns were not always addressed in a timely manner. We found record keeping was not always accurate, up to date, available and reflective of care provided.
People told us when they required support with eating and drinking their dietary needs were met. Although staff had received some training, we could not be assured training had been completed to the required standard by suitably qualified professionals. We raised these concerns with the registered person who advised us improvements to staff training were underway. Staff said they were appropriately supported within their role.
People told us they were able to make choices about their care and support and said they received care tailored to their needs. Although people told us they received person centred care, we saw no consideration had been taken to ensure information was available in a variety of formats. We have made a recommendation about this. The service had a complaints policy for managing complaints. We were told complaints were taken seriously and addressed in a timely manner.
People told us staff were kind and caring. They told us they were able to build positive relationships with staff. The registered person said they were proud of the way in which relationships were nurtured within the service.
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 supported this practice.
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)
This service was registered with us on 24/10/2018 and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about the lack of management oversight within 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 and well-led sections of this full report.
Following the inspection, we fed back our key concerns to the registered person.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Coastal Home Care Services on our website at www.cqc.org.uk.
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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.