Archived: Sevacare - Northampton

Updated 21 April 2018

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 comprehensive inspection took place on the 13, 14, 15 and 18 December 2017 and was announced. We gave the service 24 hours' notice of the inspection to ensure that staff were available to support the inspection. We visited the office location on 13, 15 and 18 December 2017 to see the registered manager and staff; and to review care records and policies and procedures. We made telephone calls to people and their relatives on 13 December and visited people in their homes on the 14 December 2017.

The inspection was undertaken by two inspectors and two experts 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 experts by experience for this inspection had experience of dementia care and they carried out telephone interviews with people who used the service and their relatives.

Prior to the inspection, the registered manager had completed 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. The provider returned the PIR within the required timescale and we took the information into account when we made judgements in this report.

We reviewed the information we held about the service, including statutory notifications that the provider had sent us; a statutory notification is information about important events that the provider is required to send us by law. We also reviewed information sent to us by other agencies, including the local authority and clinical commissioning group, who commission services from the provider.

During this inspection, we visited three people who used the service and spoke with them and their relative if they required support with communication. We carried out telephone interviews with twenty-one people and four relatives. We spoke with thirteen members of staff, including care staff, team leaders, care co-ordinators, the registered manager, area manager and a director. We looked at records relating to the personal care and support of eleven people using the service. We also looked at four staff recruitment records and other information related to the management oversight and governance of the service. This included quality assurance audits, staff training and supervision information, staff deployment schedules and the arrangements for managing complaints.

Updated 21 April 2018

This announced inspection took place over four days on 13, 14, 15 and 18 December 2017.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older and younger adults, who have a variety of support needs. At the time of our inspection there were 133 people using the service.

Not everyone using Sevacare - Northampton receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided.

There was a registered manager in post. 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 the first announced comprehensive inspection on 5 and 6 March 2015, we found the service to be rated Requires Improvement as there was no registered manager in post and communication between staff and people regarding delays or other changes to the service had not always been timely.

At the second announced comprehensive inspection on 26 May, 1, 2, 3 and 13 June 2016 the service continued to be rated Requires Improvement and the provider was in breach of one regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action to make improvements in relation to the governance of the service and the completion of medicines records. The provider submitted an action plan detailing the improvements that they would make to comply with the regulations.

At the third announced comprehensive inspection on 18, 19, 20 and 26 July 2017 the service continued to be rated ‘Requires Improvement’. We found continuing concerns in relation to the governance of the service and completion of medicines records. We also found concerns regarding the timing of people’s care visits and the actions taken in response to people’s feedback and concerns. The service continued to be in breach of one regulation and we took enforcement action. The provider was required to be compliant by the 30 September 2017.

This was the fourth announced comprehensive inspection of the service and the service continues to be rated overall ‘Requires Improvement’. The provider had not taken sufficient action to meet the breach of regulation or to comply with the requirements of the enforcement action.

There were insufficient systems in place to assess, monitor and improve the service. Where the provider had identified issues with the quality of the service they had failed to implement the

changes required.

People were not always adequately assessed for their risks or have plans of care to mitigate their known risks. There was no system in place to assess people using current standards or evidence based guidance. People at risk of malnutrition did not have their nutritional needs assessed to ensure that they were supported to maintain an appropriate diet. People were provided with the support they required to prepare their meals.

People did not always receive their care at the times agreed. Staff did not always arrive at the time specified on the rota or stay the whole allocated time.

The principles of the Mental Capacity Act 2005 (MCA) had not been followed when developing people’s plans of care. People had not been involved in the assessments of their capacity, the least restrictive options had not been explored when developing people’s plans of care and there was no evidence of consideration to whether the strategies that were being used to support people were in their best interest.

People’s medicines were administered as prescribed; however, the medicines administration records were not always completed accurately to provide a clear account of the medicines administered to people.

There was no system in place to ensure that people’s feedback and concerns were reported to the appropriate person. This meant there was a risk that people's verbal complaints would not be analysed or resolved. Where people made written complaints there were systems in place to act on them.

The provider did not have sufficient end of life care plans in place to ensure that, people that chose to stay at home as they approached the end of their life, could be supported to have a comfortable, dignified and pain free death.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service.

People's care was provided by staff that had received appropriate training to carry out their roles.

Staff had been provided with safeguarding training to enable them to recognise signs of abuse and they knew the procedures for reporting abuse.

Staff treated people with kindness and compassion. They spent time getting to know people and their specific needs and wishes. People were involved in their own care planning and were able to contribute to the way in which they were supported.

People were protected from the risk of infection by staff that complied with the infection prevention policy.

There were systems in place to ensure people with a disability or sensory loss could access and understand the information they were given. These complied with the Accessible Information Standard.

At this inspection, we found the service to be in breach of four regulations of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. Full details regarding the actions we have taken are added to reports after any representations or appeals have been concluded.