Archived: Sanctuary Home Care Ltd - Bromley

Updated 4 May 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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We undertook a focused inspection of Sanctuary Home Care Limited Bromley on 29 and 30 March 2017. This inspection was carried out to check that improvements to meet legal requirements planned by the provider after our comprehensive inspection on 12, 13 and 14 December 2016 had been made. We inspected the service against part of two of the five questions we ask about services: is the service safe, is the service responsive and is the service well led. This is because the service was not meeting legal requirements in relation to parts of those questions at the last inspection.

This inspection was unannounced and was undertaken by one inspector and an expert 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.

Before the inspection we reviewed the information we held about the service, this included the provider’s action plan, which set out the action they would take to meet legal requirements. During the inspection we spoke with 22 people and four relatives. We also spoke with the acting manager, the head of care at one location, three team leaders and three care workers across both sites. We talked with a visiting health professional, the catering staff and housing association manager who are not employed by Sanctuary Home Care Limited Bromley.

We looked at 11 people’s care records. We also looked at records held by the service including audits and checks on the quality of the service.

Updated 4 May 2017

This unannounced focused inspection took place on 29 and 30 March 2017. At the last inspection on 12, 13 and 14 December 2016 we had found serious breaches of regulations in respect of people’s safe care and treatment, the management of medicines and the management of the service. Risks to people were not always identified or assessed; medicines were not safely administered or managed. There were concerns about the management of the service and poor systems of communication between organisations which did not assure us of people’s safety.

We served two warning notices on both the provider and registered manager in respect of the more serious concerns found. We also found breaches of regulation for staff training and because people were not always treated with dignity and respect. The provider sent us an action plan to tell us how they were going to meet these regulations. We will follow up the action taken to address these breaches at our next comprehensive inspection.

This focused inspection took place on 29 and 30 March 2017 and was carried out to check that action had been taken to address the serious concerns regarding medicines, risks to people and the management of the service and ensure the regulations were being met.

Sanctuary Home Care Limited (Bromley) provides personal care at two extra care housing sites, in the Bromley area, in which people live independently in their own tenancies. The personal care service is managed from the registered office at one site. Not everyone at these sites received personal care from Sanctuary Home Care (Bromley). During the inspection we were told there were approximately 110 people who used the personal care service.

The registered manager was no longer working at this location. 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. The service was being run by an acting manager.

At this inspection we found a breach of regulation in respect of staffing. People told us there were frequently not enough staff. We found this to be the case as there were not always the assessed levels of staff required to meet people’s care needs. We also found that while improvements had been made to the way the service was managed and monitored there remained concerns about the way systems to manage emergencies and some risks were managed. You can see the action we have asked the provider to take at the back of the full version of this report.

We also wrote formally to the provider following the inspection to discuss our findings. They have agreed to send us weekly updates about staffing levels and action they take to address any problems and monthly updates on action to address the other areas identified in this report. We will be monitoring these reports closely.

Improvements had been made to the way medicines were managed and we found these were now managed and administered safely. There were some areas that still needed improvement to ensure this was consistent across the service. Risks to people were identified and assessed although some improvement was needed to ensure this was consistent across the service. Staff had received fire training since the last inspection. The kitchen had people’s up to date dietary needs. The acting manager met regularly with the housing association to try and improve communication.

The rating for the key question Safe remains Requires Improvement and we have changed the rating for Well led from Inadequate to Requires Improvement in line with our characteristics for rating each key question. This has not changed the overall rating which will be reviewed at the next comprehensive inspection.