Archived: First Practice Healthcare Limited

Updated 15 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 inspection took place on 10 August 2016. We gave the provider 48 hours’ notice to make sure that there would be someone at the office at the time of our visit. The inspection was carried out by one inspector. The inspection team also included an expert by experience who spoke to people who used the service on the telephone. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Before the inspection we looked at the information we already had about this provider. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any safeguarding matters. These help us to plan our inspection. The provider was asked to complete 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. This information was received when we requested it. We used this information to plan what areas we were going to focus on during our inspection.

During our visit to the service we spoke with the registered manager, training co-ordinator and two new members of staff who were on induction and had not yet started working with people. We sampled the records relating to three of the people using the service and six records relating to staff recruitment and training. We also reviewed records relating to the management and

quality assurance of the service. After the visit we contacted and spoke with eight people and five relatives who used the service and with two care staff.

Updated 15 October 2016

This inspection took place on 10 August 2016. We gave the provider 48 hours’ notice to make sure that there would be someone in the office at the time of our visit. First Practice is a small domiciliary care agency which provides personal care to people in their own homes. At the time of our visit there were 44 people using the service.

The service has a 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.

We last inspected this agency in June 2015. At that time the service was meeting the regulations. but some improvements were needed to make sure the service was effective and well-led. Some improvements had been made but this inspection identified further improvement was needed.

Some systems were in place to regularly assess and monitor the quality of the service. This included checks on staff competency, a range of audits such as medication and regularly seeking the views and feedback of people and staff. Improvement was needed to ensure people received a consistently good service. The registered provider had failed to display the service’s ratings from their last inspection.

We were told by people who used the service and staff, that people were supported at each call by the number of staff identified as necessary in their care plans. We received some mixed views from people and their relatives in regards to their overall satisfaction with the service they received. Some people told us that they often experienced short calls or calls that were not on time.

People told us that they felt the service kept them safe. Staff were aware of the need to keep people safe and they knew how to report allegations or suspicions of poor practice.

Those people who required assistance to take their medicines told us they were happy with how they were supported. Staff had received training and were assessed as competent to support people to take their medicines.

Staff were appropriately trained, skilled and supervised and they received opportunities to further develop their skills. All staff received an induction when they were initially employed. People described the staff as being kind and caring and staff spoke affectionately about the people they supported.

People had individual care plans and risk assessments that were regularly reviewed. Staff were not always provided with detailed information about managing risks associated with people’s conditions.

People who required assistance to eat and drink told us that they were supported by staff who understood and met their nutritional needs and preferences.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act 2005 (MCA) which applies to services providing care in the community. Although staff were aware of the principles of the MCA, they did not have access to sufficient information to enable them to understand the ability of some people to make specific decisions for themselves.

The provider had arrangements in place to deal with any concerns or complaints. People told us that they would not hesitate to contact the agency office if they had a concern. People, relatives and staff said the registered manager was approachable and available to speak with if they had any concerns.