Background to this inspection
Updated
19 May 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection checked 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.
This inspection took place on 30 December 2014 and was announced. We gave the provider 48 hours’ notice of the inspection because it was a domiciliary care service and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. We also visited an ‘extra care scheme’ on 6 January 2015 in Gosport where the service provided a team of care staff to support people in their own apartments. We also accompanied two care staff on a care visit to a person on 9 January 2015.
The inspection was carried out by an inspector and an expert by experience who completed telephone interviews to ask people, and their relatives, what they thought of the service provided by Havant Domiciliary Care. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service. It asks what the service does well and what improvements it intends to make. We reviewed the Provider Information Record (PIR) before the inspection. We also looked at our own records such as any notifications of incidents which occurred and records regarding safeguarding investigations. A notification is information about important events which the provider is required to tell us about by law.
We looked at care records for 10 people and spoke to 19 people to ask them their views about the service they received. We also sent survey questionnaires to people and relatives to ask them for their views on the service. Sixteen surveys were returned to us from people and one from a relative.
The service employed 36 staff. We looked at the records of five staff including staff recruitment, training, induction and supervision records. We spoke to three care staff, the acting manager and two team managers for the service. Survey questionnaires were sent to staff but none were returned. We also accompanied two staff on a visit to one person who received personal care and visited two people who received care at the ‘extra care scheme. We spoke with these people, observed some of the care they received and spoke with the staff who were supporting them. Records of complaints, staff rosters, satisfaction surveys, and policies and procedures were reviewed.
We contacted social services staff who commissioned services from Havant Domiciliary Care who gave us their views on the service.
This was the first inspection of this service since their registration in April 2013.
Updated
19 May 2015
This inspection took place on 30 December 2014 and was announced.
Havant Domiciliary Care provides personal care to people in their own homes. At the time of the inspection the service provided care to 82 people with a range of needs including those living with dementia and people who needed support due to old age frailty. This included personal care for 27 people in their own apartments at an ‘extra care scheme’ called Juniper Court where a staff team were based.
The service did not 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 and associated Regulations about how the service is run. There was, however an acting manager who was in the process of applying for registration with the Commission.
People, and their relatives, said they felt safe with the staff. There were policies and procedures regarding the safeguarding of adults. Staff had a good awareness of the correct procedures to follow if they considered someone they provided care to was being neglected or poorly treated.
People gave mixed views about the reliability of the service they received. Sixty- nine per cent of those who returned a survey said care staff arrived on time and 81% said they stayed for the agreed length of time. All of the people we spoke with said staff arrived on time.
People were supported by staff to take their medicines but there were numerous omissions where staff had failed to record if they had administered medicines to people. Where the provider had noted these omissions in its monitoring process sufficient action had not been taken to check people were receiving their medicines.
Checks were carried out on newly appointed staff so that people received care from staff suitable to work with them. People were supported by staff who were well trained and motivated to provide a good standard of care.
People had agreed and consented to their care. Staff sought people’s consent before providing care. There were policies and procedures for the use of the Mental Capacity Act 2005 (MCA) where people did not have mental capacity to consent to their care. Not all staff were aware of the guidance regarding the MCA and a number had not received training in this.
People’s nutritional needs were assessed and they were supported with meals and drinks. Arrangements were made to support people with their healthcare needs, such as liaising with community health services and monitoring people’s general health.
People were treated with kindness and respect. People described staff as caring and considerate. Comments were made by people about how friendly staff were. All of the people who returned a survey said the care staff treated them with respect and dignity. People were consulted about how they liked to be supported so care was provided in the way they preferred.
People said they were involved in reviews of their care needs and their care was adjusted and amended to suit their changing needs and preferences. Staff were said by people to respond to any requests for changes in how their care was provided.
There was an effective complaints procedure. People said they knew how to raise any issues they had about their care and that these were addressed to their satisfaction. Complaints were investigated and responded to by the provider.
The provider used a number of methods to monitor its performance and to check people received the right care. These included people being asked if they were satisfied with their care. Checks were made that staff behaviour and performance promoted a caring and effective service. Staff demonstrated they were committed to providing a good quality service which promoted a culture of treating people as individuals. Staff knew what to do if they had any concerns about people’s welfare and safety. Systems were used by the service’s management team to monitor that care was reviewed with people on a regular basis. Sufficient action had not been taken where it was identified by the provider’s quality assurance process that staff had not recorded if people had received their medication. Where this had occurred on multiple occasions for individual people the provider had not followed this up to check these people were receiving their medicines safely.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.