Background to this inspection
Updated
25 April 2020
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection was carried out by one inspector, and one ‘Expert by Experience'. An ‘Expert by Experience’ is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
Sagecare (Crewe) is a domiciliary care agency, providing personal care and support to people who live in their own homes.
The service had a manager registered with CQC. This means that they and the registered 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 our inspection. This is because we needed to be sure the manager and other senior staff would be available to assist us with our inspection.
Inspection activity started on 12 February and ended on 6 March 2020. We visited the office location on 12 February and 5 and 6 March 2020. Telephone calls were made to Sagecare (Crewe) people and their relatives on 19, 20 and 21 February 2020 and we visited one person who received care on 5 March 2020.
What we did:
Before the inspection we reviewed information we held about the service. This included any statutory notifications sent to us by the registered provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted the commissioners of the service to gain their views.
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.
During the inspection we spoke with the regional manager, registered manager, ten members of staff, 16 people who received personal care and five relatives. We also looked at care records belonging to six people receiving support, recruitment records for two members of staff and other records relating to the management and quality monitoring of the service.
After the inspection we continued to seek clarification from the registered manager who provided additional information including staffing and punctuality, quality assurance surveys and actions taken to improve the service.
Updated
25 April 2020
About the service:
Sagecare (Crewe) is a domiciliary care agency, providing personal care to 66 older people and 15 people with a learning disability living in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects services where people receive personal care. They receive help with tasks related to personal hygiene and eating; we also consider any wider social care provided.
The service provided for people who have a learning disability has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.
People’s experience of using this service and what we found:
People were not always supported to have maximum choice and control of their lives because the registered persons did not always work within the principles of The Mental Capacity Act 2005. This meant that people did not always receive the right type of support to help them with their decision making.
The provider had improved the service significantly in recent months, however quality assurance processes and systems were not always used effectively. We found areas of improvement regarding consent to care and complaints records that the provider had not identified or addressed.
Whilst people we spoke with made positive comments about the care, they received more than half told us that they had experienced problems with staff arriving earlier or later than expected. We could see that the provider was aware of this and had taken steps to improve staffing. We have made a recommendation about staffing levels.
Other aspects of people’s care were safe. Risk was managed proportionately, enabling people to live as independent lives as possible. Effective safeguarding systems, policies and procedures ensured people were safe and protected from abuse. Safeguarding concerns were responded to and managed effectively. People received the right level of support to assist them with their medication when required.
People were unanimous in their praise for the care staff and the standard of care they provided many of whom described the service they received as excellent. People benefited from a comprehensive assessment of their needs and care plans were developed to ensure staff had the guidance they needed to provide safe effective person-centred care.
Staff clearly understood the importance of supporting people to develop and maintain relationships and where appropriate involved families, and advocates in care and support planning processes. Where people had raised concerns with the management team, they reported that they had seen improvements.
Rating at last inspection:
This service was registered with us on 12/02/2019 and this is the first inspection.
Why we inspected:
This was a planned comprehensive inspection as part of CQC’s inspection schedule.
Enforcement
We identified a breach of the regulations in relation to ‘Consent for care and Good governance. Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up:
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.