Archived: Ark Complex Care Ltd

Updated 13 December 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 checked 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.

The inspection took place on the 25 October 2016 and was announced. The inspection team consisted of one adult social care inspector and an expert by experience who contacted people by telephone on 28 October 2016. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection visit we gathered information from a number of sources. We also looked at the information received about the service from notifications sent to the Care Quality Commission by the manager. We also looked at the information sent to us by the registered manager on the 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.

We spoke with three people who used the service and seven relatives.

We spoke with five care workers, the clinical lead, a nurse and the manager. We looked at documentation relating to people who used the service, staff and the management of the service. We looked at four people’s care and support records, including the plans of their care. We saw the systems used to manage people’s medication, including the storage and records kept. We also looked at the quality assurance systems to check if they were robust and identified areas for improvement.

Updated 13 December 2016

The inspection took place on 25 October 2016 and was announced. We gave the provider notice of our inspection in line with our current methodology for inspecting this type of service. The service was registered in January 2016 and this was the first rated inspection.

Ark Complex Care provides care and support to people of all ages who have specific needs and requirements which require a high level of clinical support to assist people to live in their own homes.

The service had a registered manager at the time of our inspection, however, they had recently left the service. The service had a new manager in place who was not yet registered with the Care Quality Commission. 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 also found that the service was operating from the company head office and not at the currently registered address. The provider submitted an application to the Care Quality Commission to make this change.

Staff we spoke with were knowledgeable about the process they would follow if they suspected abuse. They told us they received training in this area when they commenced employment with the company, and would be able to recognise abuse.

We spoke with staff who told us they had received appropriate training in medicine administration and were observed completing this task before they were able to administer medicines alone. Staff competencies were checked on an annual basis. However, the provider did not ensure that the system in place to assist staff in the safe administration of medicines prescribed on an ‘as and when’ basis (PRN) was effective.

We found the provider had a safe and effective system in place for employing new staff. We looked at staff files and found them to contain pre-employment checks and other appropriate information.

Some people's relatives we spoke with felt there were not enough staff available to support their family member. This was especially a problem when staff were off sick or on holiday. However, most staff we spoke with felt there were enough staff available to support people in line with their current needs.

Risks associated with people’s care were identified and appropriate measures were put in place to minimise the risk. This was recorded in the person’s care file.

We spoke with staff about the training they received and received mixed views. Staff told us that they received two weeks induction training when they began their employment, which covered a range of subjects. However, some staff felt this wasn’t enough for them to gain enough knowledge to support people. Some staff told us there were no specific training available which was relevant to the person they supported. However, some staff felt they had received enough training and that it was specific to their role and the people they supported.

The service was meeting the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff offered people choices and respected their decisions.

People who required support with eating and drinking were provided this. Staff we spoke with told us that food was provided based on the person’s choice and what they wanted. They told us that they tried to encourage healthy options where possible.

People had access to healthcare professionals when required. We looked at care records and saw professionals had been involved in their care.

Care plans we looked at gave information about people’s likes and dislikes but this was very basic. We spoke with the manager who told us that they were introducing a ‘one page profile’ to assist them to record this information better.

The provider had a complaints procedure and staff we spoke with explained how they would assist someone who wanted to raise concerns.

People who used the service and their relatives knew there had recently been some changes in the management team and felt this was for the better. One person said, “It has improved because we now have a main contact person in the management team, but this has only been in the last few months. We were very concerned about the service before.”

We spoke with the manager about the changes in the management team and were told that a restructure was in progress. The manager told us that from October 2016, the new structure was being introduced. The current manager would be the head of operations and there would be two registered mangers, one for the North of the country and one for the South.

There were processes in place to assess the quality of service provision. However, these were in the early stages and had not been embedded in to practice.

Our inspection identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.