Archived: West Sussex Domiciliary Care Service

Updated 8 October 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 9 August 2016 and was announced. The provider was given 24 hours’ notice because the location provides a domiciliary care service and we needed to be sure that staff would be available to talk with us.

The inspection team consisted of two inspectors, one inspector made telephone calls to people who were using the service. The other inspector visited the registered location for the service.

Before the inspection we reviewed information we held about the service including previous inspection reports, any notifications (a notification is information about important events which the service is required to send to us by law) that we had received. We had not asked the provider to submit a Provider Information Return (PIR) prior to the inspection, because this inspection was undertaken at short notice. A PIR asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We looked at safeguarding information and complaints that we had received since the last inspection. This enabled us to ensure we were addressing relevant areas at the inspection.

We spoke to ten people who use the service and two relatives in telephone calls and in person. We interviewed six members of staff and spoke with the person in charge. We spoke with two visiting health care professionals. We looked at a range of documents including policies and procedures, care records for five people and other documents such as safeguarding, incident and accident records, medication records and quality assurance information. We reviewed staff information including recruitment, supervision and training information as well as team meeting minutes and we looked at the providers systems for allocating care visits and other information systems.

The last inspection of Family Mosaic West Sussex Domiciliary Care was 25 November 2015 when a number of concerns were identified.

Updated 8 October 2016

This inspection took place on 9 August 2016 and was announced. Family Mosaic West Sussex Domiciliary Care Service provides personal care and support for older people living in their own flat within one of six extra care housing schemes in West Sussex. Extra Care housing is designed to support older people to remain as independent as possible. Extra Care facilities may include communal areas, restaurant facilities and a shop. Sometimes organised activities are available. At the time of the inspection Family Mosaic were supporting 148 people.

On the day of the inspection a registered manager was not 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. The registered manager’s role was being temporarily covered by the head of care and in this report we will refer to them as the person in charge.

At the last inspection in November 2015 we identified a number of areas of practice that needed to improve including, not always having sufficient staff to meet people’s needs and not following safe recruitment procedures. People did not always have continuity of staff to provide their care at the agreed time. Quality assurance systems were not consistently maintained to monitor and improve standards of service delivery. At this inspection on 9 August 2016 we checked to see what improvements had been made. We found that a number of improvements had been made, but there were continued concerns regarding governance arrangements and this was a breach of the regulations. You can see what action we told the provider to take at the end of the full report.

Quality assurance systems were in place, however they were not always effective in driving improvements in service. An auditing system was in place to monitor administration of medicines. Although gaps in recording had been identified and investigated, it was not clear what actions had been taken as a result to prevent further mistakes. Accidents and incidents were logged and sent to the person in charge who had oversight of all the extra care schemes. An accident had occurred and this had been logged and appropriate actions taken at the time. However, it was not clear what changes had been made following this to reduce the risk of further occurrences. This meant that the quality assurance system was not always effective and this was identified as a breach of the regulations.

People’s care plans were not well personalised and were not always updated to reflect changes in people’s needs. This meant that there was a risk that people may receive inconsistent or inappropriate care. This was identified as an area of practice in need of improvement. The person in charge was aware that care plans required updating and told us that this was work in progress.

Recruitment procedures were robust and ensured that staff were appropriate to work with people. People told us they were happy with the care provided by Family Mosaic and that the staff were kind and caring. Their comments included, “They are good as gold, some of them are absolutely brilliant, they are very caring,” and “I like all of them, I like to have a laugh with them, we get on well.” Staff knew the people they were caring for well and said that they had received the training and support they needed to care for them.

Staff had a firm understanding of how to manage risks to people and their responsibilities with regard to keeping people safe. Staff understood safeguarding procedures and were aware of the provider’s whistleblowing policy. People told us they felt safe and that there were enough staff on duty to support them. One person said, “That’s the point of living here, you have your own place, but you have the help on hand when you need it.” People told us they knew how to complain about the service if they needed to. The provider kept a complaints log and responded to people’s complaints within appropriate timescales.

People received their care visits on time and staff stayed for the duration that they expected. Staff told us they had time to cover all the calls without rushing and that they could spend time with people. People told us they received the support they needed with food and drink and that staff helped them to access health care services when they needed to. One person said, “If I am unwell the carers phone the doctor to come and see me.” Visiting health care professional spoke highly of the care staff and told us that they were knowledgeable about the people they were caring for, and proactive in seeking medical support when needed. People told us that staff had time to spend with them and that they enjoyed the activities that were on offer.

Staff spoke highly of the person in charge, one staff member said “I have never had such a good manager.” People also spoke highly of the care team managers, their comments included, “They are very efficient, kind and helpful,” and “They are very approachable.”

Staff were aware of the vision and values of the service and spoke of supporting people’s independence and providing excellent care. The person in charge was working through a clear action plan to develop the service and had completed many of the outcomes that were identified. People told us that they were happy with the service provided.