Background to this inspection
Updated
20 October 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.
This inspection was carried out on the 1 September 2016 and was announced. The inspection was completed by one adult social care inspector.
The registered provider was given a short period of notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
Before the inspection, the registered provider completed a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.
Prior to the inspection we spoke with the local authority’s safeguarding and quality monitoring teams who did not raise any concerns about the service.
During the inspection we spoke with three people using the service and two of their relatives. We spoke with three members of staff and the registered manager. We reviewed the care records for four people, and the recruitment records for four members of staff. We also looked at other records pertaining to the day-to-day management of the service.
Updated
20 October 2016
The inspection took place on the 1 September 2016 and was announced. The registered provider was given a short period of notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.
Parr Mount is an extra care service that is registered to provide personal care to people in their own homes. Extra care is where live in their own flat, however have the option of receiving care should they need it. At the time of the inspection the service was providing support to 33 people.
A manager was in post who had been registered with the CQC since October 2013. 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.
Systems were not always effective in identifying where areas of improvement were required. For example there was no formal process in place for monitoring accidents and incidents and we found that staff training was not always up-to-date. Systems had also failed to identify where risk assessments had not been completed in people's care records. You can see what action we told the provider to take at the back of the full version of the report.
Personalised risk assessments were not always completed around people’s individual needs. For example risk assessments for two people at risk of developing pressure sores had not been completed. In another example, a risk assessment had not been completed around the risks associated with one person’s diabetes. We followed up on these issues to ensure these people were safe, and found that they were. We have made a recommendation around completing risk assessments in relation to people’s needs.
Training had not always been updated to ensure that staff knowledge was up-to-date. People did not raise any concerns about the competencies of staff, and we did not observe any examples of poor practice. The registered manager had a plan in place to ensure that staff training would be brought up-to-date.
There were robust recruitment processes in place which ensured that staff were of suitable character to work with vulnerable people. New staff had been through appropriate checks, and had been through an interview process which had helped the registered manager determine their suitability for the role.
There were sufficient numbers of staff in place to meet people’s needs. The registered provider was changing the staffing rotas to increase the number of staff on shift, in response to a consultation with staff. This ensured that people’s safety was maintained, and also showed that the registered manager had involved staff in making improvements to the service.
People had been supported to take their medication as prescribed. Medication administration records (MARs) showed that staff had given these as prescribed. These were stored in people’s own homes, and care records outlined where staff were required to administer these, or where people took their own medicines.
Care records contained information around people’s life history, and preferred daily routines. This helped staff to get to know people. People told us that positive relationships had developed between themselves and staff, and that staff treated them with respect. People also confirmed that staff maintained their dignity and privacy.
Care records outlined where people required support with meal and drink preparation. People confirmed that staff provided them with the support they required with regards to this. We also observed that staff left people with juice or water to ensure that they did not become dehydrated. This protected people from the risk of poor nutritional intake.
People were supported to access support from health professionals where they required help to do so. This helped ensure people’s health and wellbeing was maintained.