Background to this inspection
Updated
5 July 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We visited the service on 4 June 2019.
Inspection team:
The inspection was completed by one inspector.
Service and service type:
Sunnybanks Home Care Service is a domiciliary care service providing personal care and support for two younger adults with learning adaptive needs/autism.
The service was not required to have a registered manager. This was because the registered provider was in day to day charge of the running of the service.
Notice of inspection:
This inspection was announced. This was because the people who used the service had complex needs for support and benefited from knowing in advance that we would be calling to their home.
What we did:
We used information the registered provider sent us in their Provider Information Return. This is information we require registered providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We reviewed other information we held about the service. This included notifications of incidents that the registered provider had sent us since our last inspection. These are events that happened in the service that registered providers are required to tell us about.
We invited feedback from the commissioning bodies who contributed to purchasing some of the care provided by the service. We did this so that they could tell us their views about how well the service was meeting people's needs and wishes. This information helps support our inspections.
We spoke with the registered provider at the service’s administrative office.
We reviewed documents and records that described how support had been provided.
We examined documents and records relating to how the service was run including health and safety, the management of medicines, learning lessons when things had gone wrong, obtaining consent and staff training.
Together with the registered provider we visited both people using the service in their home.
After the inspection visit we spoke with two support staff by telephone.
Updated
5 July 2019
About the service:
Sunnybanks Home Care Service is a domiciliary care service that provides personal care and support for children 13-18 years of age, older people, people with learning adaptive needs/autism and people with physical and/or sensory adaptive needs. The personal care is provided by support staff completing care calls to people in their own homes. At the time of this inspection two younger adults with learning adaptive needs were using the service. They lived in a property that was owned by the registered provider.
The Care Quality Commission (CQC) only inspects the service being received by people provided with personal care, where they do we also take into account any wider social care provided.
The registered provider completed most of the care calls.
The service had not been fully developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This guidance is designed to ensure that people who use social care service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning adaptive needs/or autism to live meaningful lives that include control, choice, and independence.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
People's experience of using the service:
People were positive about the service. One person said, “I love living here in my home and I get all the help I need so that I can do that.” Another person said, “Great here and no problems.”
People had not been fully supported in the right way to manage their financial affairs and had been placed at risk of financial abuse. We have made a referral about this matter to the local safeguarding authority. In addition, we have made a recommendation about how people's consent to the receipt of support is obtained including how they are supported to spend their money.
People did not always receive safe personal care and support. This was because people had not been fully protected from the risk of fire. We have made a recommendation about how people should be supported to be safe from the risk of fire.
Care calls were not robustly organised to ensure that people consistently received the assistance they needed.
People were not consistently supported in the right way to manage their own medicines.
There were shortfalls in the arrangements to learn lessons when things had gone wrong.
Support staff did not have all of the knowledge and skills they needed to provide people with support in line with national guidance.
There were enough support staff and safe recruitment practices were in place.
People were supported to prevent and control infection.
There were enough support staff and safe recruitment practices were in place.
People were supported to eat and drink enough to have a balanced diet.
People had been helped to receive medical attention when necessary.
Support staff were courteous, respectful and promoted people’s independence.
Confidential information was kept private.
People were consulted about the practical support they received and had information given to them in an accessible way.
People’s citizenship rights were respected and they were supported to pursue their hobbies and interests.
There were suitable arrangements to manage complaints.
There were arrangements to treat people with compassion at the end of their lives and to enable them to have a pain-free death.
People had been consulted about the development of the service.
Improvement action we have told the registered provider to take:
We found evidence that the registered provider needed to make improvements. This was because the registered provider had not provided support staff with all the training and guidance they needed. In addition, the registered provider had not established robust systems and processes to operate, monitor and evaluate the running of the service. This had resulted in shortfalls occurring in the service.
Please see the Effective and Well-Led sections of this full report.
Please see the ‘action we have told the provider to take’ section towards the end of the report.
Why we inspected:
This was a planned inspection based on the previous rating.
Follow up:
We have told the registered provider to send us an action plan to describe the improvements they will make to address the breaches of regulations. We will take this action plan into account and continue to monitor intelligence we receive about the service. We will we return to visit the service in line with our re-inspection programme. If any concerning information is received we may inspect sooner.