Archived: Peterborough Office

Updated 27 July 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This 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 14 and 19 June 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available in the office. The inspection was carried out by two inspectors

Before our inspection we looked at information we held about the service including notifications. A notification is information about important events which the provider is required to tell us about by law. We received feedback about concerns that had been raised from representatives of the local authority’s quality assurance and commissioning monitoring team, and safeguarding team; this helped with our inspection planning.

During the inspection we spoke with ten people who used the service. We also spoke with three relatives of people who used the service. We spoke with the provider’s representative, two interim managers an administrator and six care staff.

We looked at eight people’s care records, risk assessments, staff meeting minutes and medication administration records, complaints log and audits. We checked records in relation to the management of the service including staff recruitment records and staff training records.

Updated 27 July 2017

Peterborough Office is registered to provide personal care for people living at home. The service provides care to adults and older people, some of whom may live with a learning disability or dementia. At the time of our visit there were 52 people receiving care from the service

There was a registered manager in place. However, they had resigned and an application for them to cancel their registration had been submitted to the Care Quality Commission and was being processed. 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.

Not all risks to people had been fully assessed. Risk assessments that we saw lacked detail and did not fully explain what actions staff should take or be aware of.

Staff had received training regarding administration and recording of medicines followed by a competency check carried out by a member of senior staff. This meant that staff had been trained and assessed as competent to assist people with their prescribed medicines.

People had had their needs assessed prior to the service providing them with care. People's care plans contained information which showed their likes and dislikes and how they wished to be supported. However, the care plans we saw were vague and only gave brief details of the assistance that people required during their care visit.

There was a safeguarding process in place and staff had received training. However, people were not always protected from harm because incidents that might constitute harm had not always been appropriately reported.

There was a system in place to record complaints. However, the investigation and outcomes of complaints and how the information was to be used to reduce the risk of recurrence was not in place.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and could describe how people were supported to make decisions. Training had been provided by the service and staff were aware of current information and regulations regarding people’s consent to care.

The provider had a recruitment process in place. However this process was not always followed which meant that there was a risk that people who were not suitable to provide care were being employed. Staff received an induction when they started work and further training was available for all staff which provided them with the skills they needed to meet people’s care needs.

People and their relatives were involved in how their care and support was provided. Staff checked people’s health and welfare needs and acted on issues identified. People were supported to access health care professionals when they needed them. People were provided with a choice of food and drink.

People, relatives and staff were able to provide feedback and information informally but surveys regarding the service had not been sent out since the last inspection which was undertaken on 23 August 2016. Effective systems were not in place to monitor and audit the quality of the service provided. This meant that the provider had not always been able to identify areas for action and to be able to drive forward any necessary improvements. Notifications, that the provider was legally required to submit to CQC, had not always been received.

Staff meetings and supervision sessions were being undertaken regularly. Staff were supported by two interim managers, care supervisors, senior carers and administrators during the day. An out of hours on call system was in place to support staff, when required.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of the Registration Regulations 2009

You can see what action we told the provider to take at the back of the full version of the report.