7 December 2017
During an inspection looking at part of the service
No risks, concerns or significant improvement were identified in the remaining Key Questions through our on-going monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.
We carried out an unannounced comprehensive inspection of this service on 18 May 2017. At that inspection we found the provider had breached two regulations associated with the Health and Social Care Act 2008. Medicines were not managed safely and our concerns regarding the management of people’s medicines had not been identified through the audits in place. We therefore concluded the audits on medication were not effective. At this inspection we found continuing concerns with the safe management of medicines and governance arrangements were still not robust enough.
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults.
At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC); however, they had left the service a few weeks previously. A new manager had been appointed and told us they would be making their application to become the 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 and associated Regulations about how the service is run.
We found the provider was failing to protect people using the service against the risks associated with the unsafe use and management of medicines. Clear and accurate records were not being kept of medicines administered by staff. Gaps in the medicines administration records meant we could not be sure people were always given their prescribed medicines. Care plans and risk assessments did not support the safe handling of people’s medicines.
Systems to monitor quality and identify issues and areas for improvement at the service were not always effective or recorded well. This did not demonstrate a commitment to continuous improvement of the service.
Staff understood their role and responsibilities for maintaining good standards of cleanliness and hygiene. However, people who used the service said staff did not always wear full personal protective equipment. We informed the manager of this and action was taken to address the concern.
People who used the service and their relatives were complimentary of the staff and manager. People told us they felt safe using the service and they had consistent staff who knew their needs and provided good care.
Staff had completed safeguarding training and knew the signs of abuse to look out for and how to raise any concerns. There were enough staff to deliver care safely, and staff were recruited in a safe way.
Staff spoke positively of the management team. They told us there was a positive working culture and they were given the support they needed to carry out their roles.
You can see what action we told the provider to take at the back of the full version of the report.