This inspection took place on 19 June 2018. The last Care Quality Commission (CQC) comprehensive inspection of the service was carried out in February 2017. At that inspection we gave the service an overall rating of ‘good’.Simply Care Partners Liability Partnership LLP is a domiciliary care agency. It provides personal care to people living in their own home. At the time of our inspection twenty people were using the service. Not everyone using the service receives the regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, that is help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.
At this inspection we found some aspects of the service had deteriorated resulting in the overall rating for the service changing from ‘good’ to ‘requires improvement.’ The provider’s recruitment arrangements had not been robustly maintained. The provider had not queried discrepancies or sought additional assurances about the information provided by new staff in support of their applications to work. This meant the provider did not have all the assurances they needed about staff’s suitability to support people.
Staff supported people to take their prescribed medicines. Staff maintained written records each time medicines were administered. We noted this did not reflect current best practice issued by the National Institute for Clinical Excellence (NICE) to ensure a clear and accurate record was always maintained. The registered manager told us they would review their current medicines policy and procedure to ensure this reflected best practice.
The provider’s systems for assessing and monitoring the quality of the service had not been entirely effective. The issues we identified above around staff recruitment checks and compliance with current best practice in relation to medicines indicated a lack of management oversight of these aspects of the service which could have an impact on the quality and safety of the support people received. The registered manager said they would be taking immediate action after this inspection to rectify the issues we found. The provider wrote to us after the inspection to advise they had updated the written record staff were required to complete so that this reflected current best practice
Notwithstanding the issues above we found checks of other aspects of the service were regularly undertaken to review quality and safety in these areas. These included checks of people’s records, ‘medicines observations checks’ to review staff’s competency in this area and unannounced spot checks to people’s homes to observe staff’s general working practices when undertaking their duties. Where any gaps or shortfalls were identified through these checks prompt action was taken to remedy these including supporting and encouraging staff to learn from mistakes.
There were enough staff to meet people’s needs. People and their relatives were satisfied with the continuity, consistency and timeliness of support they received from staff during weekdays. However, they had mixed experiences about the support provided by staff at weekends. The provider was already aware of these concerns and had used their learning from people’s complaints to make required improvements. Feedback obtained by the provider from recent quality checks indicated that timeliness of visits appeared to have improved which was confirmed by a relative we spoke with. We will check at the next inspection of the service whether this improvement had been sustained and maintained.
People said they were safe when being supported by staff. Staff were well supported to take appropriate action to ensure people were protected if they suspected they were at risk of abuse. Staff had access to current information and guidance on how to minimise identified risks to people due to their specific needs. This helped to keep people safe from injury or harm.
People contributed to the planning of their care and support. Their care needs and specific preferences for how these should be met were set out in their personalised support plan. People said staff could meet their needs. Staff reflected the diversity of people using the service. This gave people more choice about who they received support from. Senior staff reviewed and updated people’s care and support plans as their needs changed to ensure staff had up to date information about the support people required.
Staff received regular and relevant training and were well supported by the provider to help them meet people's needs. They followed good practice to ensure risks to people were minimised from poor hygiene and cleanliness when providing personal care and when preparing and handling food.
People said staff were caring, considerate and provided them with support that was dignified, respectful and which maintained their privacy always. Staff supported people to be as independent as they could be.
People were supported to eat and drink sufficient amounts to meet their needs. Staff documented the support provided to people which kept others involved in people’s care up to date and informed. Staff monitored people’s general health and wellbeing and when they had concerns about this they took prompt action so that support could be sought from the relevant healthcare professionals.
People were satisfied with the care and support they received. The provider sought people’s and staff’s views about the quality of care and support provided and how this could be improved. People knew how to make a complaint if needed and the provider had appropriate arrangements in place to deal with these.
The service had a registered manager in post. People and staff spoke positively about the registered manager and said they were accessible and supportive. The registered manager understood their registration responsibilities particularly with regards to submission of statutory notifications about key events that occurred at the service.
The provider worked in partnership with other agencies to develop and improve the delivery of care to people. They worked collaboratively with local authorities funding people’s care so they were kept up to date and well informed about people’s care and support needs. This helped to ensure people continued to receive the appropriate care and support they required.
We checked whether the service was working within the principles of the Mental Capacity Act (MCA) 2005. The registered manger was trained in the MCA and were aware of their responsibilities in relation to the Act. Records showed people’s capacity to make decisions about aspects of their care was considered when planning their support.
At this inspection we found the provider in breach of legal requirements with regard to fit and proper persons employed. You can see what action we told the provider to take with regard this breach at the back of the full version of the report.