Archived: Housing & Care 21 - Kingsway

Updated 11 June 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

In accordance with our guidance we gave the provider 24 hours’ notice that we were undertaking this inspection; this was to ensure a manager was in the office to meet us. This announced inspection took place on 5, 6 and 9 May 2016 and was carried out by one adult social care inspector.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We saw evidence that the previous registered manager had attempted to submit the PIR before they left the service but this information was not received by CQC. The regional operations manager told us they had not been made aware of this.

Before the inspection we reviewed previous inspection reports and notifications the provider had made to us. We also contacted the local authority contract monitoring and safeguarding teams and the local Healthwatch service to request information they held about the service.

During the first two days of the inspection we visited the registered office and spoke with the service manager from Preston who was deputising for the regional operations manager as they were on annual leave. We also spoke with the two service managers responsible for the day to day running of the Blackburn branch, the recruitment manager, the quality assurance manager and six members of care staff. With permission we also visited seven people in their own homes and spoke with two people by telephone. Following the visits to the registered office we spent the third day of the inspection speaking by telephone with a further 10 people who used the service, three relatives and the operations manager.

We looked at the care records and medication records for nine people who used the service. We also looked at a range of records relating to how the service was managed; these included recruitment and training records, quality assurance audits, and policies and procedures.

Updated 11 June 2016

This was an announced inspection which took place on 5, 6 and 9 May 2016. We had previously carried out an inspection in September 2014. We found the service to be meeting the regulations we reviewed at that time.

Housing & Care 21 (Blackburn branch) is based at Kingsway and is registered to provide a domiciliary care and reablement service to people living in their own homes in Blackburn with Darwen and East Lancashire. The service is also the designated care provider for four extra care housing schemes located in East Lancashire. The service user group mainly consists of older adults although the provider is registered to deliver a service to adults over the age of 18. At the time of our inspection there were a total of 274 people using the service.

When we undertook the inspection the service did not have a registered manager in place. 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 previous registered manager had left the service in January 2016. The regional operations manager had taken over the responsibility for managing the Blackburn Branch until a permanent replacement was appointed. Their application to the Care Quality Commission to add the Blackburn branch to their registration was approved on 11 May 2016. The service therefore had a registered manager in place from that date.

Improvements needed to be made to the way medicines were managed in the service. One person told us they had not been given their medicines as prescribed on the day prior to the inspection. Risk assessments we reviewed had not all been updated to take into account the updated medicines management policy for the service. This meant there was a risk staff would not be aware of the support people required to ensure they received their medicines as prescribed.

Staff had been safely recruited. Staff had received training in safeguarding adults. They were aware of the correct action to take if they witnessed or suspected any abuse. Staff were aware of the whistleblowing (reporting poor practice) policy in place in the service and were confident that they would be listened to if they were to raise any concerns.

People who used the service told us they had no concerns about their safety when staff were supporting them. They told us staff were kind and caring and would always undertake any tasks requested of them. However, three people also told us that staff sometimes appeared rushed and did not have the time to chat with them.

Risk assessments for physical and mental health needs as well as any environmental risks helped protect the health and welfare of people who used the service. Arrangements were in place to help ensure the prevention and control of infection.

Support plans contained sufficient information to guide staff on how support should be provided. Staff completed a record of each visit they made. A system was in place to ensure support plans were regularly reviewed and updated. This helped to ensure they fully reflected people’s needs.

Where necessary people who used the service received support from staff to ensure their health and nutritional needs were met.

There was a comprehensive induction programme in place which included training in safeguarding, moving and handling, safe handling of medicines, nutrition and hydration and health and safety. Following the award of the reablement contract for East Lancashire all staff had also received training in the principles of this approach to supporting people to regain their independence after their discharge from hospital. Staff were also required to complete at least 21 hours shadowing more experienced staff before they were allowed to work independently in people’s homes.

Staff received regular supervision. Regular staff meetings also took place which were used as a forum to discuss service issues. The meetings also enabled staff to put forward suggestions as to how the service might be improved.

The provider was working within the principles of the Mental Capacity Act 2005 (MCA). Staff were able to tell us how they supported people to make their own decision. The managers in the service were aware of the process to follow should a person lack the capacity to consent to their care.

Although most people told us they received the care they needed, a small number of people told us they were not always consulted about changes to their care. One person told us staff had not responded to concerns they had raised regarding how their care was delivered. We were provided with evidence to show that action had been taken immediately following this inspection to rectify this matter.

There was a complaints procedure in place. We were told that all serious complaints were logged and monitored centrally by the provider. Any lessons learned from these complaints were shared with the relevant service. We noted that more minor complaints were documented at the registered office. However we saw that staff had not fully documented the action they had taken in response to one complaint received. This meant there was a risk the service would not be able to identify where improvements could be made.

Staff told us that they enjoyed working in the service. They told us communication and leadership within the service had improved following changes to the management in the branch. The service had a range of policies and procedures in place to help guide staff on good practice.

All the staff and managers we spoke with during the inspection demonstrated a commitment to providing high quality care. They were able to tell us of the areas where they felt improvements could be made in the service and the actions which had been taken to address any shortfalls identified through quality monitoring processes.