Background to this inspection
Updated
19 June 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our 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.
This inspection took place on 12 April 2018 and was announced. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection.
The inspection team consisted of one inspector. Before the inspection we reviewed the information we already held about this service. This included details of its registration, previous inspection report and any notifications they had sent us. Registered providers must notify us about certain changes, events and incidents that affect their service or the people who use it.
During the inspection we spoke with the company director and one care worker. We looked at records relating to the three people who used the service including care plans and risk assessments. We looked at other documentation including three staff files, policies and procedures and quality assurance. After the inspection we spoke with one person who used the service and one relative.
Updated
19 June 2018
The service is registered to provide personal care to people in their own homes. At the time of the inspection there were three people receiving care from the service.
This inspection took place on 12 April 2018 and was announced. We informed the provider 48 hours in advance of our visit that we would be inspecting. This was to ensure there was somebody at the location to facilitate our inspection. The inspection team consisted of one inspector.
There was a registered manager at this 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 our last inspection in August 2017 we found breaches of legal requirements and the service was issued two warning notices and placed in special measures. The service did not have robust information about people who used the service and their medical backgrounds and needs. Risks assessments were not robust and were unclear as to how the risks identified were mitigated. Information about how people’s medications were managed were not recorded in a person centred way. In addition, care plans were not personalised and did not contain information about people’s histories or personal preferences. Care plans had inconsistent identifying information within them about people’s names. The service was not monitoring training needs for care staff and staff supervision was not taking place. The registered manager did not maintain an accurate, complete or contemporaneous record in respect of each service user within care plans, within their quality audits or their support of care workers. Recruitment was not always safe as the provider did not always obtain references for new employees.
At this inspection, we found that some improvements had been made and the service is no longer in special measures, however we still found that not all regulations were met. We found the provider was in breach of three regulations of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. You can see what actions we have asked the provider to take at the end of the full version of this report.
The service was not always safe. Risk assessments were still not robust and did not contain information for support workers to follow to manage risks.
Management continued to lack insight and understanding on how to develop thorough risk assessments and what it meant to manage risk and prevent harm.
Care plans lacked detail about people’s preferences and how to support people in a personalised way.
People and their relatives told us they felt safe and support workers knew what to do in an emergency situation.
People had regular and consistent support workers that were punctual.
Recruitment practices were safe and references and checks were obtained by the provider.
All staff had received mandatory training and refresher training had been arranged.
Staff supervision and appraisals were taking place.
People and their relatives told us support workers were caring and positive relationships had been formed.
The service had a complaints procedure and people knew how to make a complaint.
Team meetings were taking place and the provider was carrying out quality assurance practices.