Background to this inspection
Updated
20 June 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, 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 team was made up of an adult social care inspector and an 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. The area of expertise for this expert by experience was in caring for older people and dementia care.
Service and service type: Human Support Group – Plymouth, is a domiciliary care service that provides personal care to people living in their own homes in the community.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. They had recently been registered and were supported by the area manager during the inspection.
Notice of inspection:
We gave the service 2 days’ notice of the inspection site visit because we wanted to ensure there would be staff available in the office.
Inspection site visit activity started on 29 April 2019 and ended on 2 May 2019. We visited the office location on 29 and 30 April 2019 to see the manager and office staff; and to review care records and policies and procedures.
What we did:
Before the inspection: we reviewed the information we held about the service and notifications of incidents we had received. A notification is information about important events which the service is required to send us by law.
During the inspection,
We spoke with:
four staff members
the registered manager
the area manager
we looked at:
six staff recruitment files
nine people’s care records
Audits and quality assurance reports
Records of accidents, incidents and complaints
We contacted:
eleven people and four relatives by phone and visited three of these people
three staff by phone
the local authority commissioning officers.
Updated
20 June 2019
About the service: Domiciliary care agency
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to adults of all ages, who may have needs including physical disability, dementia and mental health needs. At the time of the inspection the agency was providing personal care to 140 people.
People’s experience of using this service:
People told us their calls were not always at the time they had agreed with the agency, and they often did not know which staff were coming or at what time. For some people this meant they felt unsafe as they needed to have medicines or food at a certain time to remain healthy. People told us they did not always get informed when staff were going to be late. People told us they did not always know which staff members to expect.
People’s records did not always detail risks relating to their needs. When risks were detailed, guidance for staff to reduce the risk was not always included. Medicines management processes did not always reflect best practice.
Checks and audits had been completed to help ensure improvements were made. However, no checks were completed of how punctual people’s calls were, or to ensure improvements requested by people had been implemented. Not all the gaps we identified had been highlighted through the checks completed. Complaints were responded to, but evidence was not available to show whether the actions required as a result had been taken. We have made a recommendation about this.
People told us the staff were kind and responsive to their needs. Staff described how they offered choice and control throughout their visits to people. People’s care plans described how to help people maintain their independence.
People told us they felt safe when staff were supporting them, and that staff were skilled to meet their needs. Staff ensured any information required by other health or social care professionals was recorded clearly and as requested.
The provider was in the process of updating records and processes to better reflect best practice.
Rating at last inspection: Good. 18 October 2016
Why we inspected: We inspected this service as part of the scheduled programme.
We issued breaches of the regulations. Please see the end of the report for details of the action we have told the provider to take.
Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk