This inspection took place on 5 September 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. Phone calls to people and staff were completed on 6 and 8 September 2017.The service provides personal care and support to people who live in their homes in and around the Bassetlaw and Sherwood area of Nottinghamshire. At the time of this inspection between 90 and 100 people received support from the agency, most of whom 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.
Improvements were required to some records to ensure they were accurate and complete; including medicines administration record (MAR) charts, care plans, risk assessments and investigations into complaints. In addition, systems and processes designed to assess, monitor, improve services and reduce risks to people were not always effective. Some policies and procedures contained out of date information and did not always fully cover the procedures operated by the service.
Risks were not always fully identified and information on the actions required to reduce risks had not always been included in people’s care plans and risk assessments.
There was a risk that people would not receive their medicines consistently and as prescribed as care plans were not in place for when people received care with their medicines and creams. Records for medicines administration were not always complete or accurate.
People felt safe with the care staff provided and staff had been trained in how to identify and act on any suspected signs of abuse. Staff had been trained in areas relevant to people’s needs and their competency to provide care to people was checked.
Sufficient numbers of staff were suitably deployed to meet people’s needs. Recruitment processes were in place and had been followed. Staff received supervision and feedback on their performance; any shortfalls were identified with individual staff so they had the opportunity to develop and improve. Staff felt supported by the registered manager.
Staff checked people consented to their care before this was provided. Where a person lacked the capacity to consent to their care, the provider had a policy and procedure in place to follow to ensure their care would be provided in line with the Mental Capacity Act 2005.
People were cared for by staff who were kind and thoughtful. Staff promoted people’s dignity and privacy. People were involved in planning and reviews of their care and support and their views were respected.
People received care so that they received sufficient food and drink that met with people’s known preferences. Staff understood when to involve other healthcare professionals to ensure people maintained good health.
People received personalised and responsive care and were involved in reviewing what care they needed. People knew how to raise any worries or concerns should that be needed. A process was in place to investigate and respond to complaints. The registered manager was approachable and sought people’s views on the quality of the service.
At this inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of this report.