21 September 2016
During a routine inspection
At our previous comprehensive inspection on 07 December 2015, we found breaches of regulations because the provider did not take steps to ensure records were clear and up to date and complete. Records did not always provide clear information and guidance for staff on how to support people to meet their needs. At this inspection we saw that the provider had addressed these issues. However we found other issues of concern.
Kent Social Care Professionals Ltd – Bexley SCP is a domiciliary care agency that provides care and support for people living independently in the London Borough of Bexley and the surrounding areas. At the time of this inspection 148 people were using the service.
The registered manager had resigned from the service in July 2016, meaning a registered manager was not in post at the time of our inspection, but they did remain on our register. Following the inspection we were notified that a new manager had taken up the appointment of manager and they were going to apply to be the registered manager for the service. A registered manager was not in place at the service between July and September 2016. 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.
At this inspection we found breaches of legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We took enforcement action and served a warning notice in respect of a breach found of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 because adequate systems were not in place to monitor the quality and safety of the service provided. The service failed to effectively operate the Electronic Call Monitoring (ECM) system and carry out internal audits to monitor the quality and safety of the service and identify shortfalls.
Medicine records showed that Medicine Administration Records (MAR) were not always completed to demonstrate that medicines had been administered. One person who had been using the service for over six weeks did not have a care plan in place to ensure the service was meeting their needs. These issues were a breach of regulation 12 of the Health and Social Care Act 2008 (Regulated Activities Regulations 2014). You can see what action we told the provider to take in relation to the above breaches at the back of the full version of the report.
Complaints were not handled in line with the provider’s complaints policy. This was a breach of regulation 16 of the Health and Social Care Act 2008 (Regulated Activities Regulations 2014).You can see what action we told the provider to take in relation to the above breaches at the back of the full version of the report.
There were enough staff but they were frequently late in delivering people’s care.
People told us they felt safe. Safeguarding adult’s procedures were robust and staff understood how to safeguard the people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to. The service had systems in place to manage accidents and incidents whilst trying to reduce reoccurrence.
The provider conducted appropriate recruitment checks before staff started work to ensure staff were suitable and fit to support people using the service.
Staff training was up to date. Staff received supervision, appraisals and training appropriate to meet people’s needs and enable them to carry out their roles effectively. There were processes in place to ensure staff new to the service were inducted into the service appropriately.
The manager and staff understood the Mental Capacity Act 2005 (MCA) and acted according to this legislation. People’s nutritional needs and preferences were met and people had access to health and social care professionals when required.
People were treated with kindness and compassion and people's privacy and dignity was respected. Staff encouraged people to be as independent as possible.
Except for the one person who did not have a care plan in place, people were involved in their care planning and their care, support they received was personalised, and staff respected their wishes and met their needs. Care plans and risk assessments provided clear information for staff on how to support people using the service with their needs. Care plans were reflective of people's individual care needs and preferences and were reviewed on a regular basis.
Peoples' care files were kept both in the person’s home and in the office. People were supported to be independent where possible.
Staff said they enjoyed working for the service and they received good support from the manager. There was an out of hours on call system in operation that ensured that management support and advice was always available to staff when they needed it.
The provider took into account the views of people using the service, relatives and staff through undertaking surveys and holding regular staff meetings.