27 July 2016
During a routine inspection
The service did not have a registered manager, although the current manager told us they intended become registered with us. 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 who use the service were not always safe. Risk assessments were inconsistent, and had not always been completed. People were supported to take their medicines safely when needed. People who used the service told us they felt safe and staff knew how to recognise the signs of abuse and what to do if they thought someone was at risk.
Although there were enough staff to meet people’s care needs the provider was using a lot of agency staff to provide care. Feedback about the agency staff was mixed, with most people commenting that agency staff did not know their care needs as well as permanent staff. Staff did not have regular training, but supervisions and appraisal was up to date. All of the appropriate pre-employment checks had been completed before staff began working for the provider. Comments from people about staff included “they’re so good”, “Most of the staff know what they are doing”, and a relative said, “I can’t fault the carers. They know their job”.
People’s care needs were not always regularly assessed. The manager was working to ensure that people and those important to them were involved in making decisions about their care. People knew how to make a complaint or raise concerns with the manager and told us these were acted on when they did so. There was an appropriate complaints system in place and any complaints had been thoroughly investigated.
People were asked for their consent appropriately and the manager and staff had a basic understanding of the Mental Capacity Act 2005 (MCA). This legislation provides a legal framework for acting and making decisions on behalf of adults who lack the capacity to make decisions for themselves. People were treated with respect and their privacy was protected and the manager and permanent staff knew the people they cared for well and spoke about them in a kind and caring way.
Incidents and accidents were reported and investigated, but not always fully analysed to assess if there was any action that could be taken to prevent the incident from happening again.
The provider had carried out audits to ensure they were meeting the requirements of the regulations. However, concerns that had been identified were not addressed due to a lack of senior manager oversight. This had now been addressed and plans were in place to make sure the improvements made by the manager were continued. People were asked for their feedback about the quality of the service, and told us where areas for improvement were identified appropriate action was taken.
The manager knew the people who use the service well and was aware of the attitudes and behaviours of staff.