Archived: Anne Geddes Specialist-Care

Below is a summary of what we found. The summary is based on speaking with people using the service and their relatives and from looking at records. The service was providing or arranging personal care for two people at the time of the inspection. At our previous inspection in April 2014 we had found that the service needed to improve the recruitment and training of staff and have more effective communication with people using the service and / or their relatives.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service or their relatives had no concerns about the safety of the care provided. Recruitment practice had improved and checks were made before care workers were employed. Records showed that successful applicants' previously acquired training certificates and induction training with the service indicated that new staff had enough training to provide appropriate care. However whilst the service had all this information for their own staff they did not have this when they had arranged it through another service. Although the provider undertook spot checks of the service this could put people at risk of harm.

We asked the provider to tell us what they are going to do to meet the requirements of the law to ensure that they have appropriate systems in place to assess and monitor the service provided by the other service.

Is the service caring?

People were supported by kind and attentive staff. Comments made by people who used the service and their relatives were positive: "(Care worker's name) is absolutely super we could see that they would be very good at once," "We can have a laugh and a joke its good to have someone young" and "Care workers (arranged by the service) know what they are doing and know what it is important to let (my relative) maintain what they can do for themselves."

People's preferences, interests, and diverse needs had been recorded in people's care plans and people were supported as much as possible with these interests.

Is the service responsive?

Since our inspection in April 2014 the service had improved on the communication with people who used the service and / or their relatives. They told us: "I cannot fault them about keeping in touch, they are very helpful and communicative" and "Communication has improved (the provider) generally sends an email or a text to keep us updated." We saw records that included a survey completed by a relative and this showed that some issues of concern had been addressed. We noted in the service's complaint record they had considered the concerns from the service's last inspection.

Is the service well-led?

Since our last inspection the registered manager has left the service. This meant the service was in breach of a condition of their registration to have a registered manager. A director of the company was managing the service and was considering applying for registration.

Systems to ensure that people received a consistently good service needed improvement. Concerns were raised that all of the service wanted could not yet be provided and that emergency shortfalls were not adequately planned for. The appropriate steps had not been taken to gain assurances that when another registered service provided care workers that these care workers were safe and competent to provide the personal care needed. The provided however did undertake spot checks and speak with involved relatives.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to having in place an effective system for assessing and monitoring the service provided to improve the quality and to manage any risks.

Below is a summary of what we found. The summary is based on speaking with people using the service, their relatives, a member of staff supporting them and from looking at records. The service was providing personal care for two people at the time of the inspection and had been registered with us in August 2013.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service found that the service was safe. However, both people had actively involved relatives who could monitor the care provided. At times there had been shortfalls in service and the provider had not ensured that the person and/ or the relative had been informed. Recruitment practice was not consistently safe and thorough enough to ensure that any identified risk to people had been investigated. There was insufficient written evidence of successful applicants' previous training and induction with the service to be confident that care staff had the skills, qualifications and experience to provide the specialist care required. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to recruiting new staff and providing staff with appropriate training.

We spoke to both people who used the service and their supporting relatives. Amongst their comments were: "The care workers were pretty raw and we had to train them but X (name of a care worker) is excellent' and "We are totally involved in what happens with (my relative)."

We checked people's care plans and found that these were detailed and up to date. Risks were identified and for the most part plans were detailed enough to ensure that people had the care provided safely and risks to them and / or other people were minimised. Staff we spoke with were aware of the care that people needed to keep them safe. The service had proper policies, procedures and contact telephone numbers in relation to safeguarding vulnerable people and the member of staff we spoke with was aware of their responsibility to keep people using the service safe.

Is the service effective?

The people and their relatives we contacted told us that the service provided support in a personalised way. For one person this meant that the service would provide assistance at the time that they needed it and for the other that their relative was being supported to maintain their independence and attendance at some activities.

Care staff provided care in the way that they were supposed to and mostly were prompt and stayed for the right amount of time. We were told of some service shortfalls for one person.

The service was new and had yet to ask people who used the service, relatives and involved professionals to comment on the service provided. This meant that the service could lose the opportunity to improve the service to meet people's needs more effectively.

Is the service caring?

People were supported by kind and attentive staff. Comments made by people who used the service and their relatives were positive: "The care staff are really nice, I think it helps my relative that two men are helping him. They love him to bits," "I can tell care staff how I like things to be done and I am comfortable when they help me," "Yes it seems to be working out" and "On the whole we are positive about the service and ... X (member of care staff) is excellent."

People's preferences, interests, and diverse needs had been recorded in people's care plans and people were supported as much as possible with these interests.

Is the service responsive?

People who had capacity to understand knew how to make a complaint if they were unhappy. Relatives told us that they were able to raise their concerns as they had met the manager and the provider of service. We were told that there had been some 'teething problems' with the service initially, with it being a new service, but these were being resolved.

We looked at some of the daily records of people who received the service. We found where there had been issues the information had been passed from staff to staff to ensure that the person received consistent support. For example staff communicated well when supplies of certain items were getting low.

Is the service well-led?

The service was led by a manager and provider who had the qualifications, skills and experience to provide a good, well led service. The service had been registered with us since August 2013 but had only started providing services in December 2013. Systems had yet to be fully developed to ensure that all aspects of the service met regulations and best practice guidance.

The service had a complaint system in place, but had yet to implement routine quality assurance contacts with people who used the service and other people supporting the person's care.

Systems to ensure that people received a consistently good service needed improvement. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to having in place an effective system for assessing and monitoring the service provided to improve the quality and to manage any risks.