South Norfolk Carers Limited

Updated 18 May 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by an inspector, an inspection manager and 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.

Service and service type:

This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. There was a service manager who supported the registered manager in the day to day running of the service and a medication officer who was responsible for overseeing the management of medicines.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit because managers are often out of the office supporting staff or providing care. We needed to be sure that somebody would be available to support the inspection.

What we did:

Before the inspection we looked at all the information that we had about the service.

• This included information from statutory notifications. Statutory notifications include information about important events which the provider is required to send us by law.

• We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

• We also contacted professionals working with the service for their views.

During the inspection

• We spoke to the registered manager, the service manager and eight support staff.

• We spoke to 12 people who used the service and 4 relatives.

• We reviewed five people’s care records.

• We looked at the medicine administration records (MAR) and supporting documents for 11 people.

• We looked at records relating to the governance and management of the service.

• After the inspection we asked the registered manager to send us further documents which we received and reviewed.

Updated 18 May 2019

About the service: South Norfolk Carers is a is a domiciliary care agency that was providing personal care to 96 people at the time of the inspection.

People’s experience of using this service:

• Systems and processes in place to protect people from risk of abuse were not robust.

• Risks to individuals were not always assessed or monitored.

• Medicines management was not based on current best practice and there was no systematic way of identifying and investigating errors in administration.

• The registered manager told us that they would organise further training for the medication officer and the introduction of auditing tools to improve medicine management.

• There were enough staff to meet people’s needs and people had regular care staff.

• There were procedures in place to help protect against employing staff who were unsuitable to work in the service.

• People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible; the policies and systems in the service did not support this practice.

• Care needs were not consistently assessed in people’s files.

• Staff had received the training they needed to carry out their roles. There was an induction programme in place for all new staff.

• The service worked with other healthcare professionals such as GP’s, district nurses and occupational therapists.

• People told us that the care staff were kind and caring. Staff knew people well which enabled them to provide consistent care.

• The service manager regularly rang people to review their care. However, it was not always clear in the files what had been updated as a result of these calls.

• People were supported with end of life care and staff received training as part of their induction.

• Systems and processes in place to monitor the quality of care were not robust.

• There was no system in place to support continuous improvement and learning from mistakes.

• Staff gave positive feedback about managers and said that they were open and approachable.

• The service worked well with the local community to support people’s care.

Rating at last inspection: At the last inspection the service was rated as good. (Report published 14 July 2016).

Why we inspected: This was a scheduled planned inspection based on the previous rating.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated requires improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk