Background to this inspection
Updated
17 January 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the 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.
At the last unannounced, comprehensive inspection completed on 12 November 2015, we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to staffing, safe care and treatment, need for consent, receiving and acting on complaints and good governance. We asked the registered provider to take action to make improvements. The registered provider wrote to us to say what they would do to meet legal requirements in relation to these breaches. We undertook this comprehensive inspection to check that the registered provider had followed their plan and to confirm that they now met legal requirements.
This inspection took place on 16 December and we spoke with people and staff via telephone on the 19 and 20 December 2016.
The inspection team consisted of one adult social care inspector and an Expert by Experience. The Expert by Experience had experience of supporting older people.
Prior to the inspection visit we reviewed the information we had about the service. We reviewed the action plan from the previous inspection in November 2015 where the registered provider stated how they would meet the breaches in regulations we identified. We also viewed notifications sent by the registered provider to the Care Quality Commission. We contacted local authority commissioners prior to the inspection.
During the inspection we reviewed eight people’s care files and looked at six staff records. We contacted 20 people and their relatives by telephone and spoke to eight care members of staff as well as the registered manager, deputy manager, regional manager, co-ordinator and a recruiter.
Updated
17 January 2017
We inspected this service on 16 December 2016. The inspection was unannounced. We spoke with people and staff on the 19 and 20 December 2016.
At the last unannounced, comprehensive inspection completed on 12 November 2015, we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to staffing, safe care and treatment, need for consent, receiving and acting on complaints and good governance. We asked the registered provider to take action to make improvements. The registered provider wrote to us to say what they would do to meet legal requirements in relation to these breaches. We undertook this comprehensive inspection to check that the registered provider had followed their plan and to confirm that they now met legal requirements.
The service is registered to provide personal care to people in their own homes. At the time of our inspection the registered provider had 316 people using its 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. At the time of our inspection there was a registered manager in post.
We found that all the breaches of regulation found in our visit in November 2015 had now been met.
We found all care plans had not been reviewed. There was a risk therefore that people’s needs had changed. We did see the service had consulted with people about their care via telephone calls and quality visits.
Staff told us they were supported by their management and could get help and support if they needed it. Staff did receive supervision through observations and discussions but these were not always recorded.
People were protected by the service’s approach to safeguarding and whistle blowing. People who used the service told us that they were safe, could raise concerns if they needed to and were listened to by staff. Staff were aware of safeguarding procedures, could describe what they would do if they thought somebody was being mistreated. The registered provider had in place clear guidance to staff regarding gifts and gratuities to prevent people from being placed at risk of financial abuse.
People we spoke with who received personal care felt the staff were knowledgeable, skilled and their care and support package met their needs. People who used the service told us that they had a team of staff, who were generally reliable and arrived when expected.
The service had systems to ensure staff were appropriately recruited and trained. The service had introduced the Care Certificate for new staff and staff were being supported to achieve National Vocational Qualifications in health and social care.
The staff undertook the management of medicines safely and in line with people’s care plans. The service had health and safety related procedures, including systems for reporting and recording accidents and incidents. The care records we looked at included risk assessments, which had been completed to identify any risks associated with the person’s environment and delivering the person’s care.
People’s consent had been obtained by the service to deliver care and people and their relatives and carers told us the service was caring.
The service had considered people’s food and fluid intake and put in place specific plans to meet individual people’s needs.
The registered provider had in place a statement of confidentiality and staff we spoke to understood the statement.
The service had in place arrangements to gather information about people before they visited people to assess their needs before delivering care. Care plans were person centred.
There were quality assurance systems in place to gain the views of people using the service and to check on the safety and quality of the service.
During our inspection we found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.