Archived: Synergy Homecare - Stoke-on-Trent

The inspection took place on 2 November 2017 and was announced.

There was a registered manager at this service, but they were absent from work at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.

At our previous inspection on 16 and 17 May 2016, we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to consent; safe care and treatment; and good governance. The provider was issued with a warning notice in regard to these breaches, which specified they must comply with the Regulations. At this inspection, we found the provider remained in breach Regulation 17, good governance. Additional breaches of Regulation were also identified. These were in relation to receiving and acting on complaints, and notification of incidents.

The provider had not always followed their own recruitment process, which meant there was a risk of unsuitable people being employed to care for people.

There had been a recent period of three months where people's calls had been missed, or the carer had arrived late. Risk assessments were in place in relation to people's individual care and support needs, but more information was needed about how to keep people with certain conditions safe.

People's confidential care records were not always stored securely. Whilst there was a system in place for capturing feedback and complaints, these had not always been responded to or acted on.

Although staff were working within the requirements of the Mental Capacity Act, their knowledge and understanding of this key legislation was not at the necessary level.

The registered provider had investigated allegations of abuse and harm and informed the local authority, but had not informed the Care Quality Commission, as they were required to do.

Medication audits were regularly carried to ensure staff's practice was in keeping with current best practice and that people received their medicines safely and as prescribed.

There was consistency in regard to people's carers, with an understanding of the importance to people of having regular carers. People enjoyed positive and respectful relationships with staff.

People were supported to maintain their health and with their eating and drinking needs. Changes in people's health and wellbeing needs were responded to.

The provider ensured information was provided to people in a format which suited them. The provider showed regard for equality, diversity and human rights.

Staff felt supported in their roles and were enthusiastic about recent improvements and changes.

The provider's quality assurance systems had identified the current shortfalls in the service, and an action plan was in place to address these.

Sevacare Stoke-on-Trent are registered to provide personal care. People are supported with their personal care needs to enable them to live in their own homes and promote their independence. At the time of the inspection the service supported 75 people in their own homes.

We found that the manager shown on our records as being registered with us (CQC) had left the service three months ago and there was a new manager at the service who was in the process of applying to become the 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’s risks had not been assessed or monitored effectively to keep people safe. People were at risk of harm because records we viewed did not always match the support that staff told us people needed to keep them safe.

Medicines were not managed safely to protect people from the risk of harm. We could not be assured that people were receiving their medicines as prescribed.

Where relatives had consented to care on behalf of people, we found there were no mental capacity assessments carried out to ensure that decisions were made in people’s best interests. Records we viewed did not contain guidance for staff to identify if people were able to consent to their care and staff had very little knowledge of The Mental Capacity Act 2005.

We found the systems in place to assess and monitor the quality of the service were not effective. Some of the concerns we raised at the inspection had been identified, but there had been no action taken to mitigate the risks for people who used the service.

Staff had received training and an induction before they provided care, but we found they had not received training in important areas such as; The Mental Capacity Act 2005. Staff told us that the training was not always detailed and they would benefit from further training in some areas to enable them to meet people’s needs more effectively.

We found that people’s preferences in care had been considered when they started to use the service. Staff knew people well, however, the records did not reflect what staff told us and had not been reviewed or updated when people’s circumstances had changed.

People told us that staff treated them in a caring way and respected their dignity when they provided support.

Staff gave people choices in how they wanted their care provided. However, staff did not have the information needed to understand people’s ability to make choices.

Staff and the manager understood their responsibilities to protect people from abuse and were able to explain the actions they would take if abuse was suspected.

We found there were enough staff available and staffing was managed in a way that ensured people received consistent care workers who knew people well.

The provider had safe recruitment procedures and we found that the required checks had been carried out, which ensured that staff were suitable and of good character to provide care to people who used the service.

People were referred to other health and social care professionals where concerns had been raised by staff.

The provider had a system in place to handle and respond to complaints that had been made by people who used the service and their relatives.

We identified breaches 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.

People who used the service received care appropriate to their needs. A person who used the service said, 'They do everything I need. I'm keeping my fingers crossed that I can keep them'.

The service cooperated with other service providers and the wider the heath community.

There were sufficient numbers of suitably qualified and experienced staff to safeguard the health, safety and welfare of people who used the services.

Sevacare Stoke on Trent had systems in place which enabled them to continually monitor the services provided and to identify assess and manage risks to people who used the services and others who may be at risk.