23 November 2015
During a routine inspection
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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