Background to this inspection
Updated
21 August 2018
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.
The inspection took place on 27 and 29 June 2018 and was announced. The provider was given six days’ notice of the inspection, following cancellation on the day of the previously agreed inspection date by the provider, as we needed to be sure that the office was open and the provider would be available to speak with us. The inspection team consisted of one inspector and one expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Before the inspection, 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. We also looked at information we held about the agency, such as, notifications. Notifications are changes, events or incidents which the provider is required to tell us by law. We used all this information to plan our inspection.
We spoke with the provider and one member of the three staff who provided care to people living in the community. We telephoned and spoke with four people and two relatives of people that used the service.
We looked at records held by the provider. This included three care plans, daily notes; a range of the providers policies including safeguarding, medicines and the complaints policy; the recruitment and training records of staff employed and the new auditing documentation provided by the external consultant.
This was the first inspection of Jasmine Care South East, since it was registered with us as a limited company in January 2017.
Updated
21 August 2018
The inspection was announced and carried out on 27 and 29 June 2018.
Jasmine Care South East is a domiciliary care agency registered to provide personal care for people who require support in their own home. CQC only inspects the service being received by people provided with ‘personal care’ and help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. This was the first comprehensive inspection since the agency was registered with us as a limited company on 24 January 2017. The provider had another location registered with us, that they were closing down as they had downsized the business and were in the process of transferring all documentation to this location. At the time of our inspection, they were supporting 11 people.
The provider had not at the time of the inspection, amended and re-submitted her application to become the registered manager of the service. 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.
The provider had failed to have a registered manager in place. This was a breach of section 22 of the Health and Social Care Act 2008.
The provider was currently putting processes in place to monitor the delivery of the service with the support of an external consultant. However, quality assurance auditing had not as yet been implemented. We made a recommendation about this.
The provider had suitable processes in place to safeguard people from different forms of abuse. However, the provider needed to update their copy of the local authority safeguarding documentation. We made a recommendation about this.
There was no risk assessment in place in relation to the taking of the medicine ‘Warfarin’ and any side effects staff should look out for. We made a recommendation about this.
The provider followed recruitment procedures to check that potential staff employed were of good character and had the skills and experience needed to carry out their roles. However, they were reminded about obtaining satisfactory references in line with their employment policy. We have made a recommendation about this.
The provider and staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider recognised the signs of abuse and what to look out for. There were systems in place to support staff and people to stay safe.
The provider assessed people’s needs on their first visit to the person, and then by asking people if they were happy with the care they received. People were supported to plan their support and they received a service that was based on their personal needs and wishes, however records of support required needed to be more comprehensive. The service was flexible and responded positively to changes in people’s needs. Some people were supported by their family members to discuss their care needs, if this was their choice to do so. People were able to express their opinions and views and they were encouraged and supported to have their voices heard.
People told us they were treated with dignity and respect by staff who were polite and caring. They told us that staff verbally asked for their consent before undertaking any personal care.
People were supported with meal planning, preparation, eating and drinking when required. Staff supported people, by contacting the office to alert the provider to any identified health needs so that their doctor or nurse could be informed.
The provider deployed sufficient numbers of staff to meet people’s needs and provide a flexible service.
Staff had received training as is necessary to enable them to carry out the duties they are employed to perform. All staff received induction training at the start of their employment. Refresher training was provided at regular intervals.
Staff followed an up to date medicines policy recently issued by the provider and they were checked against this and assessed by the provider. Staff were trained to meet people’s needs and were now supported through regular supervision and an annual appraisal so they were supported to carry out their roles.
People said that they knew they could contact the provider at any time, and they felt confident about raising any concerns or other issues. As well as talking to the provider at spot checks, people could phone the office at any time. People’s views were obtained through meetings with the person and meetings with families of people who used the service. The provider checked how well people felt the service was meeting their needs. Suitable arrangements had been made to enable the service to learn, improve and assure its sustainability by ensuring that all regulatory requirements were met. The service worked in partnership with other agencies to enable people to receive ‘joined-up’ care.
Management systems were in use to minimise the risks from the spread of infection, staff received training about controlling infection and had access to personal protective equipment like disposable gloves and apron’s.
Working in community settings staff often had to work on their own, but they were provided with good support and an ‘Outside Office Hours’ number to call during evenings and at weekends if they had concerns about people. The service could continue to run in the event of emergencies arising so that people’s care would continue.