Everycare (Isle of Wight) is a domiciliary care agency providing personal care for a range of people living in their own homes. These included people living with dementia and people living with a physical disability or learning disability. The inspection was carried out over the 22 and 26 January 2015 and at the time of our visit the service was providing personal care to 60 people.
The last inspection of the service took place on 16 and 20 May 2014, where we identified a breach of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. We set a compliance action in relation to the management and storage of medicines. The provider sent us an action plan stating they would be meeting the requirements of the regulation by 15 July 2014.
This inspection, which was unannounced, was carried out on the 22 and 26 January 2015. During the inspection we found the provider had completed all the actions they told us they would take.
There was a registered manager in place at the service. 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.
People using the service and their relatives told us they felt safe. However, not all risks relating to people’s health and wellbeing had been identified, assessed and had strategies in place to support staff in mitigating those risks.
The recruiting practices were not robust and did not always ensure there was sufficient information available to prevent unsuitable staff from working with people who used the service.
The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act 2005 (MCA) which applies to services providing care in the community. Although staff were aware of the principles of the MCA, they did not have access to sufficient information to enable them to understand the ability of a person living with dementia to make specific decisions for themselves.
Care staff developed caring and positive relationships with the people they supported and treated them with dignity and respect. People and their relatives described the care staff as understanding and affectionate.
There were effective systems in place for the management of medicines. Staff completed medicine administration charts correctly. There was a lack of clear guidance available to support staff with the administering of topical creams.
There was a quality assurance structure in place. However, the dip-check approach to auditing files and records adopted by the manager was not robust enough to ensure that errors and omissions were identified.
Staffing levels were based on the assessment of people’s needs. However, the service was not always able to respond appropriately to cover short term absences.
Staff had completed the necessary training to enable them to support people. They were also supported through regular supervisions, which provided an opportunity to discuss any concerns and identify learning and development needs.
Staff and the registered manager had received safeguarding training and were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.
People using the service and their relatives told us they felt the service was effective. People were assessed prior to commencing with the service to ensure the service was able to meet their needs.
Staff were knowledgeable about the people they supported and the things that were important to them, such as food preferences. They supported them to have enough to eat and drink.
When necessary staff liaised with other healthcare professionals, such as GPs, district nurses and chiropodists to ensure people received a consistent approach to their healthcare.
The provider had systems in place to promote an open and fair culture. There were structures in place to enable people and staff to comment on the culture of the service and become involved in its development.
The provider sought feedback from people using the service and their relatives in respect of the quality of care provided and had arrangements in place to deal with any concerns or complaints.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which correspond with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.