Background to this inspection
Updated
11 January 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.
At the time of this inspection there were 72 people receiving personal care from Housing & Care 21 - Leeds. Before the inspection, we sent out surveys to 49 people who used the service and 49 relatives and friends; eleven from people who used the service and three from relatives and friends were returned. We have included their responses in the inspection report.
The provider completed 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 also reviewed all the information we held about the service. This included any statutory notifications that had been sent to us. We contacted the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
This inspection took place on Monday 23 November 2015 and was announced. We told the provider we would visit on Friday 20 November. They were given notice because the location provides a domiciliary care service; we needed to be sure that someone would be in the office. An adult social care inspector, a specialist advisor in governance and an expert-by-experience carried out the inspection. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We spoke on the telephone, with nine people who used the service, five relatives and seven staff. We visited the provider’s office where we spoke with the registered manager, care co-ordinators and a senior care worker, and spent some time looking at documents and records that related to people’s care and support and the management of the service. We looked at four people’s care and support plans.
Updated
11 January 2016
This inspection took place on 23 November 2015 and was announced. At the last inspection in January 2014 we found the provider was meeting the regulations we looked at.
Housing & Care 21 - Leeds is registered to provide personal care to people in their own home. At the time of the inspection, the service had 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 2008 and associated Regulations about how the service is run.
People we spoke with told us they were happy with the care they received and were complimentary about the staff who supported them. They said the same care workers visited and staff stayed the agreed length of time. They told us the service was well managed. We sent out surveys and the responses told us everyone was happy with the care and support they received and they felt care workers always treated them with respect and dignity. Fewer people said they were introduced to their care workers before they provided care or support.
People told us they felt safe. In the main arrangements were in place for managing risk appropriately, which included completing a section in each person’s care and support plan that identified hazards, the likelihood and severity of harm, and action to remove/reduce risk. They did not use evidence-based risk assessment tools to help identify certain risks such as pressure sores and malnutrition; the registered manager assured us they would review how they carried out these assessments. Safe medicine administration practices were not followed so people were not protected against the risks of unsafe management of medicines.
People told us they made decisions about their care and we saw they or their relative/friend had signed to say they consented to care. Staff we spoke with were confident that people’s capacity was taken into consideration when care was planned and any decisions made on their behalf were in their best interests. The registered manager had identified that, where people lacked capacity, they needed to complete formal assessments and record the outcome.
People’s care and support plans contained information about what was important to the person. Everyone had a ‘pen portrait’ which provided a summary of their background, hobbies, interests, friends and family, and other key facts. The plan also contained information about people’s social life, culture, faith, and identified how they wanted to receive their care. Staff were confident people received good care and were able to tell us about people’s likes and dislikes, needs and wishes.
There were enough staff to meet people’s needs and visits were well planned. Checks were carried out before staff were employed by the agency but we noted there were some gaps in employment history which should have been followed up as part of the recruitment process. Staff told us they were well supported and their training programme had equipped them with the knowledge and skills to do their job well.
The service had good management and leadership. Complaints were investigated and responded to appropriately. Systems were in place to help make sure people received safe quality care. The registered manager had introduced positive changes and had identified further improvements to ensure service delivery met the required standard. The local authority told us, “[Name of manager] has made some significant changes to how services are delivered and staff are supported, and is very committed to delivering a quality service.”
We found the service was in breach of regulation 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 the report.
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