03 March 2015
During a routine inspection
This inspection took place on 03 March 2015. The inspection was announced. This was to ensure that a manager was available at the office to facilitate the inspection. This location is registered to provide personal care to people in their own homes. At the time of our inspection 152 people were supported by the service.
The previous inspection of this service was carried out on 11 September 2014, where we identified two breaches in legal requirements. The provider sent us an action plan and told us they would meet the relevant legal requirements by 27 January 2015. At the last inspection, we asked the provider to take action to ensure all care staff were respectful to people who used the service. This action had been completed. People we spoke with were satisfied that their current care staff treated them with respect.
At the last inspection, we asked the provider to take action to ensure people experienced improved communication with the service and the system for monitoring calls was improved. People had experienced late calls and the service had not analysed late visits effectively to enable them to address this problem. This action had not been completed. We noted some improvements had been made to office communication, however, some people told us they were still not happy with communications with the office. The provider had put in place a system for analysing late visits, however some people still received late calls and calls at times which did not meet their preferences.
The home had a registered manager. 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. On the day of this inspection the registered manager was absent from the service. The inspection was facilitated by two other managers.
We found at this inspection that the provider had ensured that people were safe. Although some people still had late calls or calls not at preferred times, the provider was working with those people to address this. Where people had critical health needs, the service ensured that times of care calls were met.
People were satisfied staff had the right competency to meet their needs. Most staff received on-going supervision and appraisals to monitor their performance and development needs. One staff member told us they did not receive regular supervision.
Staff were kind, caring and respectful to people when providing support and in their daily interactions with them. People we spoke positively about the care staff and told us they were caring, friendly and helpful.
People did not always receive care that was responsive to their needs. Whilst improvements had been made to reduce late calls and variations to people’s preferred call times, this problem had not been resolved in all cases. The provider acknowledged this and was actively working to resolve these concerns.
People were encouraged to comment on the service provided to influence service delivery to influence how the service was developed. Not everyone thought that action had been taken to address issues they had raised.
There were audit processes in place intended to drive service improvements. The provider had taken action to bring the service up to the required standards since the previous inspection. The provider demonstrated a commitment to addressing any issues and improving the service. However, further action was required, the provider acknowledged that 30 per cent of people did not have calls at their preferred time.
At the previous inspection improvements were needed to ensure positive communications with the office. We saw that the provider had recruited additional office and on-call (out of hours) staff to improve communications. Some people and staff we spoke with said that further improvements were required to ensure positive communications with the office.
Staff we spoke with had received training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This legislation sets out how to proceed when people do not have capacity and what guidelines must be followed to ensure people’s freedoms are not restricted.
Records showed that we, the Care Quality Commission (CQC), had been notified, as required by law, of all the incidents in the home that could affect the health, safety and welfare of people.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.