Archived: Ark Home Healthcare Blackburn

Updated 27 September 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.

In accordance with our guidance we gave the provider 48 hours’ notice that we were undertaking this inspection; this was to ensure someone was in the office to meet us. This announced inspection took place on 23 and 24 August 2017 and was carried out by one adult social care inspector.

Before the inspection we reviewed previous inspection reports and notifications the provider had made to us. We also contacted the local authority contract monitoring and safeguarding teams and the local Healthwatch service to request information they held about the service.

Prior to visiting the registered office, we used the 48 hour notice period to speak with 12 people who received support from Ark and five relatives to gather their views about the service. On the first day of the inspection we visited the registered office and spoke with a total of 12 staff. These were the registered manager, the branch manager, a deputy manager, two care coordinators, a team leader, six members of care staff and an administrator. On the second day of the inspection, with permission, we visited five people who used the service in their own homes to speak with them about the service. We also spoke with a further five relatives.

We looked at the care records for ten people who used the service. We also reviewed the medicine administration record (MAR) charts for six people. In addition we looked at a range of records relating to how the service was managed; these included recruitment and training records, quality assurance audits, and policies and procedures.

Updated 27 September 2017

This was an announced inspection which took place on 23 and 24 August 2017. This was the first inspection since a new provider had registered to take over the running of the service in April 2017.

Ark Home Healthcare Blackburn (referred to throughout the report as Ark) is registered to provide a domiciliary care and reablement service to adults over the age of 18 living in their own homes in Blackburn with Darwen and East Lancashire. At the time of this inspection there were a total of 468 people using the service although the provider informed us the reablement part of the service which supported 140 people was in the process of being transferred to a new provider.

The service had a manager in post who had registered with the Care Quality Commission in January 2016. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers ('the provider'), 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 registered manager was also the provider’s Regional Operations Director as well as the registered manager for another location in Preston. They were therefore supported in the day to day running of the Blackburn service by a branch manager who was based at the registered office.

People who used the service told us they had no concerns about their safety when staff were supporting them. They told us staff were kind and caring and would always undertake any tasks requested of them. Staff informed us they always had sufficient time to spend with people and recognised the importance of ensuring people did not feel rushed when they were providing personal care.

People spoken with told us they had no concerns about the support they received from staff to take their medicines. However we saw that not all medication administration record (MAR) charts contained the dosage and administration instructions for each person’s prescribed medicines. In addition medicines audits had not always been sufficiently robust to identify when MAR charts had not been fully completed.

Staff had received training in safeguarding adults. They were aware of the procedure to follow should they witness or suspect abuse. They told us they would also be confident to report any poor practice they observed from colleagues and were confident their concerns would be taken seriously by the managers in the service.

Six of the seven staff personnel files we reviewed contained all the required pre-employment checks. One personnel file contained only one reference; this was not in accordance with the provider’s own recruitment policy. We noted the provider had made attempts to gain a written reference from the person’s previous employer but had not received a response. However, this had not been followed up by a verbal request in order to try and ascertain the person’s conduct in that employment.

Risk assessments were in place in relation to each individual’s physical and mental health needs as well as any environmental risks; these helped to protect the health and welfare of people who used the service and staff. Arrangements were in place to help ensure the prevention and control of infection.

Staff told us they received the induction, training and supervision they needed to be able to deliver safe and effective care. There was a comprehensive induction programme in place which included training in safeguarding, moving and handling, safe handling of medicines, nutrition and hydration and health and safety. Staff were also required to complete at least 21 hours shadowing more experienced staff before they were allowed to work independently in people’s homes.

The provider was working within the principles of the Mental Capacity Act 2005 (MCA). Staff were able to tell us how they supported people to make their own decisions and choices.

Care records were personalised and provided detailed information for staff to follow in order to maintain people’s preferred routines. Staff completed a record of each visit they made which included how they had gained consent from people for the care they had provided.

Where necessary people who used the service received support from staff to ensure their health and nutritional needs were met. Each person’s care records contained a hospital emergency transfer form. This included important information about the person’s medical condition and the people involved with their care should they require treatment in hospital.

People spoke positively about the kind and caring nature of staff. They told us staff always respected their dignity and privacy and listened to their views. Two care staff in particular were singled out by a number of people for the excellent care they delivered.

People had opportunities to provide feedback on the care they received. We noted that comments made by people during support plan reviews had been very positive. We saw evidence that any complaints received were fully investigated in line with the provider’s complaints procedure.

Staff told us they enjoyed working for Ark and that improvements had been made to the way the service was run since the change of provider. They told us the registered manager, branch manager and other senior staff were approachable and supportive. Regular staff meetings meant that staff were able to make suggestions about how the service could be improved. Staff told us their views were always listened to.

There were systems in place to monitor the quality and safety of the service. The registered manager demonstrated a commitment to continuing to drive forward improvements in the service.