The inspection took place on 13 and 14 June 2018 and was announced, this was to ensure staff we needed to speak with were available. This was the first inspection due to the service being new so we could not gather any information from past reports.Vine Social Care is a domiciliary care agency; it provides personal care to people living in their own houses and flats. It provides a service to older and younger adults who may be living with a physical disability, a mental health condition, a learning disability or people living with dementia. At the time of the inspection, 29 people were using the service.
We identified breaches of two Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and one breach of Care Quality Commission (Registration) Regulations 2009. You can see what action we have taken at the back of the full version of the report.
The provider had a recruitment process to make sure the staff they employed were suitable to work in a care setting. However these were not always consistent and some staff had commenced employment without the required checks being completed.
Risks to people were assessed and action was taken to minimise any avoidable harm to people. Staff were trained to know the signs of abuse and how to report these in line with policy and procedures. However, the provider had not consistently reported these concerns to the relevant safeguarding teams. The provider had failed to notify the CQC and relevant agencies of safeguarding concerns which could have resulted in people not being kept safe.
Medicines were managed safely. Staff who administered medicines were appropriately trained, however staff did not receive medicines management competency checks so the provider could not be assured that staff were competent. There were unaccounted for gaps in people’s medicine administration records (MARS) charts which had not been identified in the provider’s audits There was no evidence of anyone coming to harm with regards to the management of their prescribed medicines.
The service had 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.
There was guidance in place to protect people from risks to their safety and welfare, this included the risks of avoidable harm and abuse. Staffing levels were sufficient to support people safely and where there were any short falls these were covered internally or with agency staff.
Staff were aware of the importance of infection prevention and control and their responsibility to ensure that infection risks were minimised. Staff had access to appropriate personal protective equipment (PPE).
Staff raised concerns with regard to safety incidents, concerns and near misses, and reported them accordingly. The registered manager analysed incidents and accidents to identify trends and implement measures to prevent a further occurrence.
People's needs had been assessed and they had a written care plan to meet their identified needs.
People were supported by staff who had the required skills and training to meet their needs. Where required, staff completed additional training to meet individual's needs. People were supported to have a balanced diet that promoted healthy eating.
The registered manager involved a range of external health and social care professionals in the care of people, such as: community nurses, physiotherapists and GPs to enable them to be supported to live healthier lives.
The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service did not currently support any individuals who required assessments under the MCA.
People experienced consistency of care from staff who were kind and compassionate. People told us the staff were very caring and kind. People told us they were involved in making decisions about their care and that their wishes were respected. Staff ensured people's privacy and dignity was upheld at all times.
The service was responsive and involved people in developing their care plans which were detailed and personalised to ensure their individual preferences were known. People's care plans had information about their care needs, as well as their wishes regarding independence and any risks identified and how to minimise these. If a person's needs changed, their care plans were updated immediately.
Arrangements were in place to obtain the views of people and their relatives and a complaints procedure was available for people and their relatives to use if they had the need.
The registered manager provided support to staff. The safety and quality of the support people received were monitored. However, the quality assurance systems used had failed to identify some shortfalls in the service.