We carried out an announced comprehensive inspection of this service on 28 January 2015. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to medicines management and staff training and support. During this comprehensive inspection on 16 February 2016 we checked that the provider had followed their plan and to confirm that they now met legal requirements.Parkgate Nursing Agency provides care and support to people living in their own homes. There were 26 people using the service when we visited.
There was a registered manager 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.
At this inspection, we found that improvements had been made so that medicines were managed safely but we found that there were still some improvements to be made in relation to staff training and support.
Care workers told us they had completed medicines administration training within the last three years and were clear about their responsibilities.
Risk assessments and support plans were provided by the referring social worker. The managers of the organisation visited people to assess whether the information they had been provided was correct, but they did not produce their own care plans or risk assessments. As a result we found some information had not been updated in one person’s care record. However, the registered manager confirmed that she had visited the person and that their needs had not changed. This was confirmed by the referring social worker after our inspection and we were sent a copy of their report with updated risk assessments.
Safeguarding adults from abuse procedures were documented and care workers understood how to safeguard people they supported. Care workers were able to explain the possible signs of abuse as well as the correct procedure to follow if they had concerns.
Care workers demonstrated a good knowledge of their responsibilities under the Mental Capacity Act 2005.
Care workers demonstrated a good knowledge and understanding of the people they supported, however, these details were not recorded in people’s care records.
People using the service and their relatives told us they were involved in decisions about their care and how their needs were met.
Recruitment procedures ensured that only care workers who were suitable, worked within the service. There was an induction programme for new care workers, which prepared them for their role. However, care workers training records were incomplete and care workers did not receive formal supervision or appraisals of their competence to carry out their roles to ensure any development needs were met.
There were enough care workers employed to meet people’s needs and where two care workers were required at a visit the provider ensured that this was always the case so that people’s needs were met safely.
People were supported to maintain a balanced, nutritious diet, where this was part of the package of care being provided to them. People were supported effectively with their health needs and were supported to access a range of healthcare professionals.
People using the service and care workers felt able to speak with the registered manager and provided feedback on the service. They knew how to make complaints and there was a complaints policy and procedure in place.
The provider’s systems for monitoring the quality of the service was not always effective. The registered manager reviewed all care records and daily notes completed by care workers, but this did not identify the issues we found. We saw evidence that feedback was obtained by people using the service and the results of this was positive. There was no evidence that either member of the management team supported or monitored care workers completion of training modules.
We have made a recommendation in relation to quality monitoring.
During this inspection we found a breach of regulations in relation to staff training and support You can see what action we told the provider to take at the back of the full version of the report.