Archived: The Energy Centre

We undertook this inspection over two days on 10 and 11 February 2015 and the inspection was unannounced, which meant the registered provider did not know we would be visiting the service.

This was the first inspection of the service since it was registered in June 2013.

The Energy Centre is a care agency owned and managed by Clark James North Lincolnshire Limited. The service provides personal care and support services to people living in North Lincolnshire. Services provided range from a few hours support several times a week, to 24 hour support every day. People who used the service included; older people, people with dementia, learning disabilities, autistic spectrum disorder, mental health needs, physical disabilities, sensory impairments, children 0-18 and people who misused drug and alcohol. At the time of our inspection the service was providing a service for up to eighty people of all ages.

The registered provider is required to have a registered manager in post and on the day of the inspection. There was a manager registered with the care Quality Commission (CQC); they had been registered since 10 January 2014. A registered manager is a person who has registered with the Care Quality Commission to manager the service and has the legal responsibility for meeting the requirements of the law; as does the registered provider.

All but one of the people who used the service told us they had positive relationships with their carers and their care was delivered to a high standard.

While staff told us they knew the people they were supporting and people who used the service told us they provided a personalised service; there were differences in the training care staff had received. Staff told us they felt they needed more specialised training.

Some staff had been recruited with training from previous employers while others had accessed it at the service after their appointment. There was no evidence to demonstrate that staff with previous training skills had their competencies assessed in the workplace after they had been offered employment with the agency.

Training records showed that fifteen staff had received training in the principles of the Mental Capacity Act 2005. Staff told us the availability of this training needed to be extended. We observed staff took steps to obtain people’s verbal consent prior to care and treatment being offered.

Few staff had received regular supervision or appraisal. In the records for staff who had received supervision that were in place, identified actions had not been carried out.

The problems we found breached Regulation 23 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the registered provider to take at the back of the full version of the report.

Staff had received training in safeguarding vulnerable adults from abuse. Staff knew how to protect people from abuse and they ensured the equipment they used in people’s homes was regularly checked and maintained.

The registered provider had policies and systems in place to manage risks, safeguard vulnerable people from abuse, undertake safe recruitment of staff and for the safe handling of medicines.

Assessments had been undertaken to identify people’s health and support needs. Care plans did not always record or identify how people wished to be supported or provide guidance for staff, in order to meet their needs in their preferred way.

Before our inspection visits we had been made aware of concerns that some people’s care plans and risk assessments were not detailed and were not signed by the individual. Where people were unable to sign for themselves there was no record of this in place

Care plan records varied and we found some were detailed and informative while others contained inconsistent or limited information. Risk assessments were not in place for all of the people who used the service. Where these were in place they were not all signed or identified a date for review. This did not provide staff with all of the information they required in order to meet people’s needs. The content of care records and risk assessments needed to be more detailed and personalised. We have made a recommendation about more person centred care planning for staff.

Records showed the registered manager had put in place a new updated care plan system and had implemented a structured approach to the review of care plans and risk assessments. Care plans were in the process of being audited by the registered manager, reviewed and updated to ensure the information required in order to support people was in place. All were planned to be completed within three months.

Medicines were not always handled safely. Most medicines were supplied in a monitored dosage system. This was used to support the safe administration of medicines in the home. However we found that information in care records did not always reflect the information on medication administration records (MARS).

People who used the service told us they knew how to complain. We saw information on how to make a complaint was contained in the ‘Service User Guide’ within people’s homes.

Staff told us the leadership and management of the service had improved and was good. There were systems in place to monitor the quality of the service and we found this had not been effective and had missed areas that required improvement. For example; there had been one survey of the people who used the service, but there were no action plans in place to address the areas identified as requiring improvement following this.

Staff told us there were enough staff to fulfil the rota, with staffing levels based on individual’s dependency and this was monitored and adjusted depending on the needs of people.

The registered provider told us that people were at the heart of the service, and the service did their upmost to organise care and support to suit their individual needs. For example people who used the service who required a high level of support from the agency, had a team of carers allocated to them in order to provide continuity. Some people who used the service had been involved in the staff selection process.

However, they recognised that the service had developed more quickly than they had originally planned for and in order to provide services to people some of the organisational systems in place had not been developed to the level they had wanted. This they felt had been a contributory factor in the areas identified as requiring improvement. They had as a management team, already identified the areas that required further action and had begun working to improve these areas.