Archived: Southampton Community Care Services DCA

Southampton Community Care Services DCA provides personal care and support to people in their own homes. At the time of this inspection the agency was providing a service to 75 people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age. The agency is managed from a centrally located office base in Southampton.

At our last inspection on 04 and 11 June 2015, we found two breaches of regulations. The service was non-compliant with people’s risk assessments and people’s care plans. During this inspection we found action had been taken and improvements made.

A registered manager was not in post at the time of our inspection. 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. The service was currently in the process of registering the manager for the regulated activity of personal care.

People and their families told us they felt safe and secure when receiving care. However, staffing levels were not always sufficient to take into account people’s needs and the time were not always provided when people would like them to suit their needs. The manager was aware of our concerns and actions had already been put in place. People’s medicines records were not always recorded appropriately by staff leaving some gaps in medicines administration records and information on where to apply cream was not always clear.

Safe recruitment practices were followed and appropriate checks were undertaken, which helped make sure only suitable staff were employed to care for people in their own homes. Staff received training in safeguarding adults and child protection for when they came into contact with children. Staff told us they felt supported and received regular supervisions and support. Staff meetings were held quarterly.

People’s risk assessments and those relating to their homes’ environment were detailed and helped reduce risks to people while maintaining their independence. The service had introduced a training tool to be more pro-active known as the ‘Mears Prevention System (MPS). People were able to access healthcare services.

People who used the service felt they were treated with kindness and said their privacy and dignity was respected. People were supported to eat and drink when needed. Staff had an understanding of the Mental Capacity Act (MCA) and were clear that people had the right to make their own choices.

Staff were responsive to people’s needs which were detailed in peoples care plans. Care plans provided comprehensive information which helped ensure people received personalised care. People felt listened to and a complaints procedure was in place.

Staff felt supported by the manager and felt they could visit the office any time and be listened to. Staff meetings were held regularly and staff were recognised in these meetings for their hard work and dedication. There were systems in place to monitor quality and safety of the service provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

At the time of the inspection the regulated activity Treatment of Disease Disorder or Injury was not provided by the location. Therefore this report refers to an assessment of the service's provision of the regulated activity personal care.

We assessed the service against five outcomes: care and welfare, safeguarding, medicines management, staffing and assessment of the service quality.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led

This is a summary of what we found-

Is the service safe?

The provider trained staff in safeguarding responsibilities systems were in place for the agency to follow when safeguarding concerns arose and promote people's safety.

The provider had put systems in place to eliminate the risks associated with medicines management. However, people were not protected because errors in recording were not always addressed in a timely way to ensure medicines had been administered safely.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to medicine management.

Is the service effective?

People told us they had been asked about the care they wanted before it was provided and care-plans had been put in place. They said their care needs were usually met by regular staff but it was not always effective when there were frequent changes in the staff and in the timing of their care.People told us the care from unfamiliar staff was sometimes less effective because they did not always familiarise themselves with their needs leading to inconsistency and people feeling a lack of respect.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to employing suitable numbers of staff.

Is the service caring?

People who received care from regular carers told us they told us it was either 'all right', 'fine ', 'good' or 'excellent'. We received comments such as the care had been 'improving', the 'girls' were 'pretty good 'and 'always asked if there was anything else they could do' before leaving and that care was 'not hurried', 'very caring 'and 'very nice'.

Is the service responsive?

Systems were in place to obtain feedback from people who use the service through individual reviews and surveys. However, the responsiveness of the service is not fully effective. People who use the service were not always confident that complaints or concerns would be or had been dealt with. People also said they had not always had or have effective communication with the agency.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the quality of the service in ensuring people's complaints are addressed.

Is the service well-led?

Systems and procedures have been put in place or developed to increase the monitoring of the service and develop the quality assurance systems. More audits of the service have taken place and improved the leadership and culture of the service.

People were encouraged to give their consent to care and support whenever possible. Where people did not have capacity to consent, the service responded to ensure their rights and well-being were protected in line with legal requirements.

The people spoken with were positive about the care and support provided by care staff, particularly their regular carers. Several people told us the care and support they received from staff was 'brilliant'. One person said care staff were 'absolutely amazing.' We reviewed plans and records of care for five people who used the service, and found they were person-centred and contained essential information about people's different care, health and welfare needs.

The service's systems for the management and recording of medicines were not effective. This resulted in the risk that people did not receive all their medication in line with their specific health needs.

Issues with missed and late calls, and unannounced staff changes, identified a risk that there were not enough staff to meet people's needs at all times.

People's comments and complaints were not always listened and responded to appropriately. The provider's systems for monitoring and auditing did not effectively highlight all issues that needed to be addressed as part of the provider's quality assurance programme.