6 September 2016
During a routine inspection
There was a registered provider in post who was also the registered provider. A registered provider is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. For ease we have referred to the registered manager as the ‘registered provider’ throughout this report. The registered provider assisted us with our inspection.
The registered provider was not following the requirements of the regulations in relation to recruitment processes. We found some application forms were not available in staff files and there was no evidence that references for some staff had been sought for staff before they commenced work.
The registered provider did not always ensure staff followed safe medicines management procedures as we found gaps in people’s medicines records. Some best practice processes in relation to medicines management were not undertaken.
Quality assurance processes had been introduced to obtain feedback from people as to the care that was provided to them. Other quality checks were carried out by the registered provider, such as auditing the daily notes written by staff. However, some of the areas we identified as requiring action had not been picked up by the registered provider which showed they needed to have a better management oversight of the agency. As this was a small service the impact to people was minimal however we have made a recommendation to the registered provider that they continue to improve their quality assurance processes.
Although staff had the opportunity to meet together, formal meetings had yet to be established. This was because the agency was new and there was a small staff team which the registered provider saw on a regular basis.
Staff were not always provided with relevant training to ensure they were equipped to undertake the role. The registered provider relied on training that staff had completed in previous roles and although they carried out an induction with new staff, there was a lack of evidence to show this had always been done. Supervisions had not been carried out with staff in line with the timescales the registered provider told us they should be.
Risks to people had been identified and information available to staff to show what action should be taken to help avoid people coming to harm. Should people need to get hold of someone outside of office hours, they had been provided with an out of hours contact number.
Although care records for people were up to date they were not particularly person-centred and did not always contain individualised information about people which may help staff get to know the person. However, staff said they knew people and found the information they had been provided with was sufficient to enable them to give the care people required. Relatives said staff knew their family member well.
There was a sufficient number of staff available to ensure people received care when they were expecting it. Staff were allocated travelling time between people and would inform people if they were running late. Staff were provided with a written rota to show them where they needed to be each day and any changes to a person’s care was emailed or telephoned through to staff. When someone new commenced with the agency the registered provider always met the care staff at the person’s home to introduce them and ensure that they knew exactly what care was required.
People and relatives told us that staff were kind and caring and they were very pleased with the care the agency provided to them. People had signed to show they consented to the care and treatment being provided to them.
Staff were aware of their responsibilities in relation to safeguarding people from abuse and knew how to report any concerns they may have. Accidents and incidents had not been recorded so far as this was because none had occurred with people since they had commenced with the agency. There was a complaints procedure in place which was made available to everyone once they commenced with the agency.
People were supported to eat and drink sufficient amounts. If people required it staff would refer people to a health care professional.
During the inspection we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made some recommendations to the provider. You can see what action we told the provider to take at the back of the full version of the report.