The Inspection took place on 25 June 2018 and 9 July 2018 and it was announced at short notice to ensure the registered manager was available. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older people, some of whom may be living with dementia.
There was a registered manager in post. 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.
Improvements were needed to the recruitment process. The registered manager had obtained some of the appropriate checks for the current care workers but we found they had started work prior to receiving them all. Care worker’s references could not be verified as they were not on headed paper or stamped by the company providing the reference. You can see what action we told the provider to take at the back of the full version of the report.
People told us they felt safe, and except for the shortfalls identified in the recruitment process, were protected from the risk of harm by the systems, processes and practices in the service. Care workers were trained and felt well supported, and knew how to safeguard people.
The registered manager, who is also the provider, and the office manager were supporting with the direct delivery of care whilst they continued to recruit more staff but this has meant a reduced capacity to ensure that all aspects of the management and monitoring of the service was being handled as robustly as needed. This had led to a breach of regulation in relation to recruitment of staff and further concerns regarding the robustness of risk assessments in all instances.
There were systems in place for managing people’s medicines should the service need to do so in the future. Care workers had access to personal protective equipment and were trained in infection control.
People told us that their care workers were very caring, kind, compassionate and genuine. They said the service was very reliable and responsive to their needs. People’s needs had been assessed and catered for and were regularly reviewed and updated.
The service provided people with the support they needed with their meals and drinks. Monitoring charts were in place, where required to ensure that people had sufficient nutrition to meet their needs. People were supported with their healthcare needs when required.
The service worked in line with other legislation such as the Mental Capacity Act 2005 (MCA) to ensure that people had as much choice and control over their lives as possible.
People were treated with dignity and respect, and care workers were supportive, whilst encouraging people to regain skills and maintain their independence. People were fully involved in any decisions about their care and support. The registered manager had access to advocacy services should people need them. An advocate supports a person to have an independent voice and enables them to express their views when they are unable to do so for themselves.
People received personalised care that was responsive to their needs. They were confident any concerns and complaints would be listened to, acted upon and resolved to their satisfaction. The registered manager said they would learn from complaints and make changes to ensure that people received an improved service.
People’s confidential information was stored safely in line with data security standards.
Further information is in the detailed findings below.