25 January 2017
During a routine inspection
This unannounced comprehensive inspection took place on 25 and 26 January 2017 and was undertaken by one inspector.
At the time of our inspection there was no registered manager in post. The agency was being managed by a manager who was in the process of applying to the CQC to be registered. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the agency. 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 provider and manager had not always notified the Commission about important events that, by law, they are required to do so. This limited the information available to the Commission and any potential action that may have been required to be taken. Systems were in place to monitor the quality of service that was provided and improvements made had been effective.
Staff had an understanding of how to protect people from harm and of the appropriate reporting procedures and organisations responsible for investigating any safeguarding concerns. However, not all incidents had been reported to the Commission.
Staff, prior to being offered employment, were subject to a rigorous process of checks on their suitability to work with people. For example, previous employment history, police records checks, recent photographic identity and written references.
People were cared for and looked after by a sufficient number of suitably skilled staff. People’s needs were met by staff who knew them well.
People’s medicines were administered as prescribed. Staff who had been trained to administer medicines had their competency to do this assessed regularly. People had their medicines managed safely.
People were supported by staff to eat and drink sufficient quantities of the foods and drinks that they preferred. People were supported to access healthcare services and their healthcare needs, as a result of this, were met.
The CQC is required by law to monitor the Mental Capacity Act 2005 [MCA] and to report on what we find. The provider was aware of what they were required to do should any person lack mental capacity. Appropriate applications were in progress to support people through the Court of Protection. This showed us that the manager and care staff were aware of, and liaised with, those lawful bodies that were responsible authorising and deprivations of people’s liberty. Staff had a good understanding about the application of the MCA and its code of practice.
Staff received the training they required to meet people’s needs. New staff were shadowed by experienced staff until they were able to work more independently. An on-going programme of training and staff development was in place and this gave staff the necessary skills they needed.
People received care from staff who provided this with kindness, sensitivity and compassion and promoted people’s well-being. People’s care was provided in private and in a way that respected their rights. People were involved, or were assisted with this by relatives or representatives, in developing their care plans. Care plans were reviewed and kept up-to-date.
Staff supported people to be as independent as possible. People had as much or as little support as they needed.
People’s, staff’s and relatives views were sought and any issues identified were acted upon promptly. Actions taken in response to any concerns raised were effective in preventing the potential for recurrence.
The manager was supported by a head of quality, care coordinator, field care supervisor and a team of care staff who benefitted from the support they were provided with. Staff understood what was expected from them and demonstrated the values of the provider to provide the best care that they could.