Archived: Portsmouth

Updated 6 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is 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.

This inspection took place on 26 and 27 January 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

The inspection team consisted of three inspectors.

Before the inspection we reviewed previous inspection reports, safeguarding records and other information received about the service. We checked if notifications had been sent to us by the service. A notification is information about important events which the provider is required to tell us about by law. We spoke with the Local Authority safeguarding and commissioning teams. This inspection was brought forward as a result of receiving some concerning information about the service.

During the inspection we spoke with 15 people who used the service and six relatives. We also spoke with six care staff, one senior care worker, one co-ordinator, the senior co-ordinator and the registered manager.

We reviewed a range of records about people’s care and how the service was managed. We looked at plans of care for 15 people which included specific records relating to people’s capacity, health, choices, medicines and risk assessments. We looked at daily reports of care, incident and safeguarding logs, compliments, complaints, service quality feedback forms, audits and minutes of meetings. We looked at the training plan for 78 staff members and recruitment, supervision, appraisal and training records for 10 staff members. We were sent a copy of the service transitional plan as a result of the provider purchasing additional care staff and people from another care company in November 2015.

We asked the provider to send us information after the visit. We requested copies of their policies and procedures and training plan. This information was received.

Updated 6 April 2016

This inspection took place on 26 and 27 January 2016. The inspection was announced.

Portsmouth, Apex Companions Limited, provides personal care services to people in their own homes. They provide services to older people and people living with dementia. At the time of our inspection there were 180 people receiving personal care from the service. There were 70 care staff, one senior co-ordinator and two co-ordinators who planned people’s care. There were three senior care staff, one deputy manager who was on maternity leave, one administrator and a registered manager.

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.

People’s care visits were sometimes provided later than planned because travel time was not allocated. People felt safe and had regular care staff who met their needs. However, people may not always be receiving a safe service if certain aspects of their care were not provided at specific times, such as medicines, personal care and preparing meals.

People were not always supported to eat and drink at the times they requested and this could have an effect on their well-being.

The registered manager and staff demonstrated a good understanding of the Mental Capacity Act 2005 but did not always put this understanding into practice. We have made a recommendation for the provider to review the Mental Capacity Act 2005 and its subsequent codes of practice.

Feedback was sought and individually responded to. However the overall results were not analysed or evaluated to help improve service delivery. Audits were not completed or evaluated to help improve practice. Recording systems were duplicated and caused confusion on what was the most up to date information. Notifications had not been sent to the Commission for all four safeguarding concerns received by the service.

Staff received an induction programme and regular on-going training. Staff felt supported but did not always receive regular supervision in line with the provider’s policy. However, people and their relatives said they received care from regular staff and felt they were well matched with care staff and they had the skills and knowledge to carry out their roles effectively.

People were supported to maintain good health and access on-going healthcare support.

Risk assessments were completed of the environment and any manual handling equipment that would be used to support people with their care safely. Safe recruitment practices were followed.

People and their relatives were positive about the care and support received from care staff and the office staff. People were involved in their care and made decisions about their care. People’s independence, privacy and dignity was respected and promoted.

People’s needs were regularly assessed and reviewed. People’s care plans were personalised and individual, detailing how people like to receive their care. People were involved in their care planning and confirmed they had control over their care planning.

People and their relatives raised concerns with the service and felt these concerns were dealt with. People and their relatives we spoke to said they had never made a complaint but felt confident to raise one and that this would be dealt with. Complaints which had been received had been dealt with, responded to and actioned where required.

There was a registered manager and they demonstrated a good understanding of the service. There was a mixed response from people about the management and leadership of the service.

Staff felt supported by the registered manager. Staff were supported to question practice and were confident that concerns would be dealt with by management. Staff demonstrated an understanding of what to do if they felt their concerns were not listened to by management.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found a breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of this report.