Background to this inspection
Updated
1 May 2020
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
Two inspectors and an assistant inspector carried out the inspection.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 17 December 2019 and ended on 15 January 2020. We visited the office location on 17 December 2019.
What we did before the inspection
We reviewed information we had received about the service before the inspection. We sought feedback from the local authority who work with this service. The provider was asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We spoke with five people and one relative to seek their views on the service. We used all of this information to plan our inspection.
During the inspection-
We spoke with the registered manager (who is also the registered provider), two senior members of staff, the internal training provider and four staff members.
We reviewed a range of records. This included nine people’s care records and nine medication records. We looked at six staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training and quality monitoring records were reviewed.
After the inspection –
We spoke with four people and one relative. We continued to seek clarification from the provider to validate evidence found.
Updated
1 May 2020
About the service
Field House (Charter Care) is a domiciliary care agency providing personal care to 114 people in their own homes at the time of the inspection. The service mainly supports older adults, people living with dementia and or people living with physical disabilities.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People did not always receive safe care. We found inconsistencies in the recordings of prescribed creams and there was insufficient guidance in place around ‘as required’ medications. Whilst staff were able to tell us about the risks associated with peoples care, risk assessments were not consistently in place for people’s individual needs. Staff were safely recruited and understood how and when to raise any safeguarding concerns. People were protected from the risk of infection by good infection control practice.
People received effective care. People received support to eat and drink meals of their choosing and where required were supported to access appropriate healthcare. Staff had received training in people’s needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People felt supported and cared for by the staff team. People had been involved in developing a plan of care based on their preferences. Staff informed us they enjoyed their role of supporting people.
People received care that was responsive to their needs. People’s care had been reviewed to ensure it continued to meet their needs. People were aware of how to raise concerns, should they have any, and felt confident that these would be addressed.
The service was not always well led. Governance systems were either not in place or not robust. This meant that systems were not effective in monitoring the quality and safety of the service. There were systems in place to seek feedback from people and their relatives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection.
The last rating for this service was Good (published 20 June 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach in relation to the quality monitoring of the service.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.