Background to this inspection
Updated
29 November 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 17 and 18 October 2016 and was unannounced. The inspection was undertaken by one inspector.
We asked the provider 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. The form was completed and returned so we were able to take the information into account when we planned our inspection. We reviewed the information we held about the service. Providers are required by law to notify us about events and incidents that occur; we refer to these as ‘notifications’. We looked at the notifications the provider had sent to us. We also contacted the local authority who monitor and commission services, for information they held about the service. We used the information we had gathered to plan what areas we were going to focus on during our inspection.
We spoke with the acting manager and four staff members, whilst we were at the office, and two staff members on the telephone. We spoke with six people and six relatives by telephone to gain feedback about their experiences of using this service. We looked at a sample of records including six people’s care records, three staff files and staff training records. We also looked at records that related to the management and quality assurance of the service, such as complaints, rotas and audits.
Updated
29 November 2016
This inspection took place on the 17 and 18 October 2016 and was unannounced. This was because we had received some anonymous concerns about the way the service was being managed so we did not announce our inspection visit with the provider. This was the first inspection since this service was registered in November 2015. Hales Group Dudley branch provides personal care and support to 71 people that live in their own homes.
There was not a registered manager in post. There was an acting manager who has been in post for three months who has submitted her application to become 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 and associated Regulations about how the service is run.
We found that recruitment procedures were not robust to ensure all the required information was obtained before staff commenced employment. This is required to ensure staff are suitable to work with people. Staff had received training and knew how to report and deal with issues regarding people’s safety.
People told us they did not always receive a reliable and consistent service, as some people had experienced late and missed calls. People told us they received their medicines as prescribed, but the medicine records were not always completed to demonstrate this. We found that people did not always have assessments in place to demonstrate how risks associated with providing their support had been assessed and managed to ensure people received a safe service.
Staff we spoke with understood that people have the right to refuse care and that they should not be unlawfully restricted. People received support from staff that were described as respectful and caring and ensured that people’s privacy and dignity was maintained. People were supported to maintain their health.
Care plans were not in place for all of the people that used the service. The information in the care records varied in quality and content and did not include detailed information about people’s needs and preferences for the staff to refer to.
People and their relatives did not always feel listened to and complaints were not always responded to in a timely manner. Information about people and staff was not kept confidential. The acting manager was aware of these issues and was taking action to address these.
People and their relatives told us their feedback was sought about the service that they received. They told us that improvements were being made to the service they now received.
The provider failed to provide evidence that they had a clear oversight of the service through regular auditing and effective quality assurance systems. We found that the acting manager has completed her own audits so was aware of the shortfalls that we have identified.