This inspection took place on 24, 25 February and 1 March 2015. This was an announced inspection. We gave the provider 24 hrs notice of our visit because the service is small and the office staff may not be available due to supporting staff or providing care. We needed to be sure that they would be in. This was the first inspection of the service since registration with the Care Quality Commission in November 2013.
Network Healthcare (Chipping Sodbury) is a domiciliary care agency that provides personal care and support to people living in their own homes. It is part of a National company that is registered with the Care Quality Commission called Network Healthcare Professionals Limited.
The majority of people using the service required long term support to enable them to continue to live at home. On the day of our inspection there were 23 people using the service with 11 staff employed to deliver this care.
The registered manager had resigned in December 2014. 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. There is a condition of registration that this location must have a registered manager. We were told recruitment for the post of registered manager was underway.
People had not always received a service that was delivered on time and in accordance with their care plan. The agency had increased the numbers of people they were supporting whilst experiencing a high turnover of staff. This meant that the agency was unable to provide consistent care and support during the months of November, December 2014 and early January 2015. The provider had devised an action plan and worked alongside local commissioners to minimise the risks to people. Twenty seven people had been served notice by Network Healthcare to find another care provider. Comments received from people confirmed there had been difficulties and they were not always satisfied with the care and support that was in place. However, people acknowledged this had improved in the last two months.
The majority of the people were receiving a service as planned. However, there was one package of care where there were not enough staff to provide the full seven day package of care.
People were at risk of unsafe medicine administration. This was because staff were not following the risk assessments and not recording medicines given. This meant people could not be assured they were receiving their medicines in a timely manner or as prescribed where they required support.
There was a lack of quality monitoring being completed to enable the provider to make a judgement on how effective and responsive the service was. This included making any improvements to people’s care and support packages. Complaints were not recorded centrally so could not be analysed for any themes or trends. Some complaints had not been investigated in a timely manner with feedback given to people on how their concerns had been responded to. Some people and their relatives were not satisfied their concerns had been listened to.
People commented positively about the care staff that were supporting them. They told us they were treated kindly, with respect and the staff were caring. People told us the staff had the skills and knowledge to support them effectively. People confirmed they had a plan of care that they had agreed. Care plans clearly described the support needs of people and these were kept under review.
People told us they felt safe. Staff knew what to do if they suspected that an allegation of abuse was taking place. Staff had been through a thorough recruitment process ensuring they were suitable to work with vulnerable adults and children. New staff shadowed more experienced staff until they were confident to work on their own. Some people told us that when new staff started they had to explain to them how they wanted to be supported.
Staff confirmed they received regular training and were supported in their roles. However, it was acknowledged that this was not always the case. They said there had been a lot of pressure put on them during November and December 2014 to ensure people received the care and support they required. Staff stated they now have regular people they support enabling them to build relationships with.
We found a number of breaches 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.