Archived: PillarCare Agency

This inspection was short notice which meant the provider and staff did not know we were coming until shortly before we visited the service. At the last inspection on 7th February 2014 the provider met all of the requirements we looked at.

At the time of our inspection the provider also acted in the role of 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.

From the telephone discussions we had with people using the service, relatives and care workers we found that people were usually satisfied with the service. People were confident about approaching the registered manager and staff to talk about the things that they wished to and people felt that there was openness in the way the service communicated with them.

We saw that there were policies, procedures and information available in relation to the Mental Capacity Act 2005 (MCA) to ensure that people who could not make decisions for themselves were protected. It should be noted that the agency would not have responsibility for making applications under this legislation, however, they would have responsibility for ensuring that any decision on MCA 2005 were complied with. That applications must be made to the Court of Protection. Whether any applications had been made to the Court of Protection and If so, whether the provider was complying with any Court Order. We saw from the records we looked at that the service was applying these safeguards appropriately where applications had been made and approved, however care staff lacked knowledge about these areas.

We found that people’s health care needs were usually assessed, and care planned and delivered in a consistent way. People who used the service had a variety of support needs and from the six care plans that we looked at we found that the information and guidance provided to staff was clear. Any risks associated with people’s care needs were usually assessed, with the exception that the risk assessments did not always cover areas of risk reduction measures. For example, risk assessments did not cover the risk reduction measures for people who were at risk of developing a pressure sore. We also found that in some cases the risk assessments that were in place could be updated more regularly.

During our review of care plans we found that these were usually tailored to people’s unique and individual needs. We found that most, but not all, care plans were being reviewed regularly.

The service provided us with information about the level of qualifications amongst the 38 care workers currently employed. 14 care workers had already achieved health and social care qualifications and four had begun study for the National Vocational Qualification (NVQ 2). We were provided with a list of courses that staff had undertaken in the last year although the provider could not confirm at the time of the inspection how many staff had undertaken these courses or when they were completed. We found that the registered person had not provided sufficient support for staff by arranging suitable opportunities for staff supervision.

We found that staff respected people’s privacy and dignity and worked in ways that demonstrated this. From the conversations we had with people, and records we looked at, which showed us that people’s preferences had been recorded and that staff worked well to ensure these preferences were respected.

Records which we viewed showed that people were able to complain and felt confident to do so if needed. We saw that where people had raised issues that these were taken seriously and dealt with appropriately. People could therefore feel confident that any concerns they had would be listened to.

People who used the service, relatives and other professionals who had regular contact with the service told us that they provided their views about the quality of the service to the registered manager or other staff. There was an annual quality assurance survey being conducted at the time of this inspection, however, there was no other way of monitoring the service performance more regularly than this. 

We found the service was not fully addressing aspects of care such as compiling fully appropriate risk assessments, supporting and supervising staff or ensuring that staff were appropriately aware of the Mental Capacity Act 2005. 

You can see the action that we have told the provider to take at the back of this report.