Archived: Firstpoint Homecare - Bristol

Updated 10 March 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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 took place on 14 January 2015 and was announced and 48 hours notice of the inspection was given to ensure that the staff we needed to speak with were available. The inspection was undertaken by two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

The inspection also followed up the actions the provider had taken to meet the legal requirements following the last inspection when two breaches of regulation were found.

We reviewed the information that we had about the service including statutory notifications. Notifications are information about specific important events the service is legally required to send to us.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. They did not return the PIR and we took this into account when we made the judgements in this report.

During our inspection we spoke with 14 people who used the service some of whom were relatives. We spoke with seven members of staff that included the nominated individual/clinical lead, compliance and quality manager, operations director and a branch manager who had supported the service for the past few weeks.

We reviewed the care records of eight people who used the service, four staff files that included recruitment, supervision and training information and reviewed documents in relation to the quality and safety of the service.

Updated 10 March 2015

We carried out an announced inspection of this service on 14 January 2015. The last inspection was in July 2014 and two breaches of regulations were found. These related to a lack of effective care plans and risk assessments to keep people safe and the provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. During this inspection we found not all the required improvements had been made to meet the requirements.

Firstpoint Homecare Bristol provides personal care to people in their own homes. At the time of our inspection there were 48 people being supported by the service.

A registered manager was not in post at the time of the inspection. 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 and associated Regulations about how the service is run.

People did not always receive safe care. This was because some visits to people were late and some visits had been missed.

People said they felt safe and well looked after by their care workers. One person told us “safe, yes. For me what is good is that they always arrive wearing a uniform. I know instantly who they are even if I haven’t seen them before, and so I don’t worry about letting them in. New carers always introduce themselves.”

The senior management team told us they had a rolling programme of recruitment for care workers, although they stated they did currently have sufficient numbers of staff to undertake the current level of contracts. The provider was currently recruiting a new branch manager and office member of staff.

Not all risk assessments gave guidance for staff to follow. This was because some people had no risk assessments in place and many had not been updated. Therefore staff did not have full and up to date information to ensure people were kept safe and protected from harm.

People’s care files did not always record their care and treatment as some care plans were not in place in people’s homes. Many care plans had not been updated to reflect the person’s current circumstances that could result in people’s needs not being met by staff.

People were protected from the risks associated with cross infection. The staff followed the Department of Health infection control guidelines. Staff used personal protective equipment (PPE) such as aprons and gloves when required to reduce the risks of cross infection when assisting people.

The provider had ensured that staff had the knowledge and skills they needed to carry out their roles effectively and ensure people were safe. Staff had completed their safeguarding adults training to ensure their knowledge was current and in accordance with current guidance. An electronic system was in place to alert the senior manager when training was required.

Staff had training in the Mental Capacity Act 2005 and had a good understanding of the processes to be followed to ensure decisions were made in people’s best interests. This information was correctly recorded to help protect people’s rights.

There were positive and caring relationships between staff and people at the service, we saw this when we went to visit some people in their own homes. People praised the staff and told us they provided a good standard of care even when they were very busy.

Some people’s care records demonstrated their involvement in care planning and decision making processes as some people had signed their documentation. However some people told us reviews did not take place.

Staff meetings did not take place. The senior management team couldn’t supply evidence to support this. Therefore staff did not have the opportunity to get together and exchange best practice ideas. Staff were not supported by receiving supervisions and appraisals in line with the organisation’s policy to give them opportunities to monitor their work and development.

The quality and safety of the service was not monitored, systems had not been improved since the last inspection. Systems had not been implemented to gain people’s views on the service they received to enable improvements to be made.

We found four breaches of regulations. You can see what action we told the provider to take at the back of the full version of the report.