Archived: Concept Care Solutions - 1st Floor Middlesex House

Updated 4 January 2017

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, and to provide a rating for the service under the Care Act 2014.

Two inspectors carried out the announced inspection on 7 December 2016. We told the provider two days before our visit that we would be coming. We gave the provider notice of our inspection as we needed to make sure that someone was at the office in order for us to carry out the inspection.

Before we visited the service we checked the information that we held about the service and the service provider including notifications we had received from the provider about events and incidents affecting the safety and well-being of people.

During the inspection we went to the provider's office. We reviewed eleven people's care support plans, seven staff files, training records and records relating to the management of the service such as audits, policies and procedures. We spoke with nine people who used the service and seven relatives of people who used the service. We also spoke with ten members of staff including care support workers, field care supervisors, office staff, the operations manager and the registered manager. We also obtained feedback from one care professional who had contact with the service.

Updated 4 January 2017

We undertook an announced inspection of Concept Care Solutions – 1st Floor Middlesex House on 7 December 2016. Concept Care Solutions – 1st Floor Middlesex House is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides support to people of all ages and different abilities. The service provides a range of domiciliary care services which include domestic support, administration of medicines, personal care and live in care. At the time of inspection the service provided care to approximately 60 people.

At our last inspection on 14 December 2015 we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were in relation to the service not having effective arrangements in place for the management of medicines and not maintaining accurate and complete records. During the inspection on 7 December 2016 we found the service had taken necessary action to address the breaches of regulations identified at the previous inspection.

There was a registered manager in post at the time of our inspection. 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 who used the service and relatives informed us that they were satisfied with the care and services provided. People told us they were treated with respect and felt safe when cared for by the service. They spoke positively about care support workers and management at the service.

Systems and processes were in place to help protect people from the risk of harm and staff demonstrated that they were aware of these. Staff had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse. Risk assessments had been carried out and detailed potential risks to people and details of how to protect people from harm.

At the previous inspection in December 2015 we found a breach of regulation because the service did not have effective arrangements in place for the management of medicines at the time of the inspection. During the inspection in December 2016 we found that the service had taken appropriate action since the last inspection and there were suitable arrangements for the administration and recording of medicines. Where agreed, people told us that they had received their medicines from care support workers. Records indicated that staff had received training on the administration of medicines. We also found that the service had a comprehensive and effective medicines audit in place to monitor and identify any errors in respect of medicines administration and recording.

People and relatives told us their care support workers mostly turned up on time and they received the same care worker on a regular basis and had consistency in the level of care they received.

People were cared for by care support workers that were supported to have the necessary knowledge and skills they needed to carry out their roles and responsibilities. Staff confirmed that they received regular supervision sessions and appraisals to discuss their individual progress and development. Staff spoke positively about the training they had received and we saw evidence that staff had completed training which included safeguarding, medicine administration, health and safety, first aid and moving and handling. Staff spoke positively about their experiences working for the service and said that they received support from management.

At the previous inspection in December 2015 we found a breach of regulation because care support plans were difficult to follow and information about people’s support was not always clear and consistent. During the inspection in December 2016 we found that the service had made improvements to care support plans and had addressed this breach of regulation. Since the last inspection the service had reviewed care support plans and these were now clear and were in a new format. Care support plans included more detail about people and their care needs. They also included clear instructions for care support workers.

Staff we spoke with had an understanding of the principles of the Mental Capacity Act (MCA 2005). They were aware that when a person lacked the capacity to make a specific decision, people's families, staff and others including health and social care professionals would be involved in making a decision in the person's best interests. The service had a Mental Capacity Act 2005 (MCA) policy in place. Care plans included information about people's mental health and their levels of capacity to make decisions and provide consent to their care.

Care support workers had a good understanding and were aware of the importance of treating people with respect and dignity. They also understood what privacy and dignity meant in relation to supporting people with personal care. Feedback from people indicated that positive relationships had developed between people using the service and their care support worker and people were treated with dignity and respect.

The service had a complaints procedure and there was a record of complaints received. Complaints we examined had all been responded to appropriately. People and relatives we spoke with during this inspection expressed that they had confidence in the service and were satisfied that if they needed to complain about something, their concerns would be taken seriously and dealt with accordingly. It was evident from the feedback received from people and relatives that the service listened to people’s concerns and took the appropriate action.

People using the service spoke positively about the service and told us they thought it was well managed. There was a clear management structure in place with a team of care support workers, field supervisors, office staff and management. Systems were in place to monitor and improve the quality of the service. We found the service had obtained feedback about the quality of the service people received through review meetings and satisfaction surveys. Records showed positive feedback had been provided about the service. The service also undertook a range of checks and audits of the quality of the service and took action to improve the service as a result.