This inspection took place on 25 September and 2 October 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we wanted to visit the office, talk with staff and review records. Telephone calls to people were completed on 26, 27 and 28 September 2017. Telephone calls to more staff were made on 6 October 2017. Telephone calls to other health and social care professionals were made on 27 September and 2 October 2017. The service provides personal care and support to people who live in their homes in and around the Chesterfield area of Derbyshire and parts of Sheffield. The service cares for older people as well as people with sensory or physical disabilities, mental health needs and people with learning disabilities or people with an autistic spectrum disorder.
We asked the service to complete a provider information return (PIR). This is a form that asks the provider to give us information about the service, what they do well, and what improvements they are planning to make. This was returned to us by the provider. At the time of this inspection 121 people received support with their personal care needs.
The service is required to have 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. At the time of our inspection there was a registered manager in post.
Some areas of the service did not have sufficient staff and some people experienced late or missed calls. Care plans did not always reflect full details of the medicines people received and medicines administration record (MAR) charts had not always been completed.
Policies were in place so people’s care could be provided in line with the Mental Capacity Act 2005 (MCA) if they lacked the capacity to consent to their care; however records of mental capacity assessments and of best interest decision making had not been made by the service. Not all staff fully understood the MCA.
Some people felt care did not always promote their independence, choice and control. Some people felt care was rushed and care staff were not consistently introduced to them before their care began.
Records of people’s care and treatment, for example MCA records and medicines administration record (MAR charts), were not always recorded where needed. Records were not always accurate and completed contemporaneously. Statutory notifications had not been submitted to the CQC when required. Systems and processes designed to check on the quality and safety of services were not always effective.
Other risks were assessed and actions to reduce risks were identified; for example what steps staff should take to ensure any equipment used was safe. People felt safe and staff knew what steps to take to should people be at risk from harm or abuse. Recruitment procedures were followed to ensure staff were checked to ensure they were suitable to work at the service.
Staff received training in areas relevant to people’s needs and training dates were booked for staff identified as requiring further training or refresher training. Staff felt supported by their managers and had the opportunity of supervision meetings with managers.
People were supported to have good health and nutrition and staff knew people’s food and drink preferences.
People’s privacy and dignity was respected by staff who took steps to ensure this was promoted during care. People were involved in developing their care plans and knew they could discuss their care with staff.
The views of people and their preferences were known and respected. People had opportunities to raise issues regarding their care through feedback and knew how to complain should that be needed. People’s views were sought when the registered manager evaluated the quality of the service.
A registered manager was in place and they had taken steps to develop the service. Staff were motivated in their roles.
At this inspection we found two regulated activity breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we asked the provider to take at the back of the full version of this report.