Archived: Solent Care at Home Service

The inspection team consisted of a lead inspector and three experts by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

The focus of the inspection was to check compliance following previous non- compliance at an inspection carried out on 25 February 2014. Previous non-compliance was in regard to respecting and involving people who use service, care and welfare of people who use services, management of medicines and assessing and monitoring the quality of service provision. The provider told us they would be compliant with these outcomes by 1st October 2014.

We set out to answer our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found.

Is the service safe?

People and their relatives told us they felt safe, one person said, '[Carer] talks to me and makes me feel safe'. A relative said, 'We trust them.' We found the provider had taken the appropriate action to ensure people's care and treatment was planned and delivered in a way that ensured peoples safety and welfare, however we found there were no systems in place to make sure lessons were learned from any accidents and incidents.

We found the provider had taken the appropriate action to ensure people were protected against the risks associated with medicines because the provider had appropriate arrangements in place for the safe administration, reporting, recording and checking of medicines.

Is the service effective?

People consented to their care and treatment.

People's medicine records and risk assessments were not always accurate and fit for purpose. There were inconsistencies between people's risk assessment and medicines information that did not always correspond with their care plans. However people were not at risk of unsafe care as members of staff supporting them knew what support was required.

Is the service caring?

People and their relatives told us staff were caring. We received comments such as, 'We don't think that we could get better care anywhere else,' and, 'I can hear the kindly and reassuring way the carers speak to my relative.'

People's views and experiences were taken into account and their privacy and dignity was respected in the way the service was provided and delivered in relation to their care.

Is the service responsive?

Steps had been taken to ensure people were asked for their views about their care and they were acted on.

Appropriate steps had been taken to ensure the provider had an effective system in place to identify, risks to the health, safety and welfare of people using the service but not to assess and manage risks to the health, safety and welfare of people using the service

People and their relatives told us care plans were regularly updated and staff confirmed changes were highlighted in updated care plans.

Is the service well led?

There was a registered manager in place but they were not present on the day of the inspection due to annual leave. They had provided an action plan highlighting improvements would be made and they would become compliant by 1 October 2014. They had informed us of who would be responsible for the running of the service during their absence. We found improvements had been made since our last inspection, however there were some parts of the provider's action plan which had not been met resulting in further non-compliance.

During our inspection of Solent care at home service we spoke to 28 people who used the service, nine members of staff and the registered manager.

There were policies and procedures in place for staff to use to assist them to provide care and support to people in line with their needs and wishes. Examples of these included person centred planning policy, medicines policy, equality and diversity and Absence Management Policy. However we found that they were not always followed in practice.

People who used the service expressed their satisfaction with the service. One said 'My regular carers are brilliant' and another person said 'my carers are always very patient."

People's needs were not always accurately assessed and care, treatment and support was not always planned in line with individuals needs and preferences. Assessments we saw were inconsistent with people's care plans and we found difficulty in identifying the correct needs of the people who used the service. These were not always fully completed and it was unclear which document provide the most accurate and up to date information.

We found that the service did not follow their medicines policy and did not provide sufficient information to staff about the support needs of people. This meant that people could be at risk of receiving support that was inappropriate, unsafe and did not meet their needs.

We found that there were sufficient numbers of suitably qualified staff available to provide the service effectively.

We found that the service did not have effective monitoring processes in place to help regularly assess and monitor the quality of the service being provided.

People told us they were happy with the services provided, and were aware of their plans of care and support. People said they were given appropriate information, and were involved in decisions about their care and support. We were told by people using the service that the support they received helped them to remain living at home safely, and to remain independent.

People said their needs had been assessed and the service was planned and delivered in line with their individual plan. We were told that people felt safe and well supported by staff who knew what they were doing.

We saw that there were arrangements in place to deal with foreseeable emergencies. People who use the service were safeguarded and protected from the risk of abuse.

Staff had received appropriate professional development and training and were encouraged and supported to obtain further relevant qualifications.

We found systems in place to quality assure the service. These arrangements included the opportunity for people who use the service, their representatives and staff to be asked for their views about the services being provided and feedback was acted on.

There was evidence that learning from incidents / investigations took place and appropriate changes were implemented.

The provider took account of complaints and comments to improve the service.