This inspection of Blue Ocean Services took place on 9 January 2018 and was announced. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. Not everyone using Blue Ocean Services receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of the inspection 51 people were using the service. The service had a registered manager in post. 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.
At the last inspection on 25 February 2016, the service was rated Good. At this inspection we found that the service had not met all the regulations we inspected. We found breaches of regulation in relation to safe care and treatment, good governance and notifications of other incidents and the service has therefore been rated Requires Improvement.
The registered manager completed individual risk assessments for people. The risk management plans helped guide staff in minimising risks for people. However, we found risk management plans were not always sufficiently detailed.
Care plans were person centred and contained information about people's backgrounds and needs so staff could support them in ways they preferred. Plans contained instructions for care workers about what to do on each visit. However, we found care plans did not always contain people’s assessed needs for staff to care for people in an effective way.
Medicines were administered to people as prescribed. Staff received training to administer medicines and had their competency assessed to ensure they continued to do this safely. However, medication administration records were not always completed accurately.
Accidents and incidents were logged as were the actions to mitigate them happening again. However, we found that on some occasions that actions to reduce the risk of this recurring had not been fully implemented.
The registered manager did not always fulfil the requirements of their registration with CQC. They did not always notify us of safeguarding concerns as required by law.
The service was monitored and reviewed to ensure the care provided was of good quality. However, we found some areas of the service were not of good quality because the quality assurance systems were not effectively used.
Enough staff were available to care for people. Staff were allocated to people to provide care and support to them, where necessary two care workers were provided.
Safer recruitment processes ensured suitably skilled staff were employed to work with people. Checks were carried out on staff before they were approved as suitable for employment.
There was a safeguarding policy in place and staff regularly attended safeguarding training. Care workers understood what whistleblowing meant and said they would contact the registered manager to inform them if they had any concerns about the quality of care.
The registered manager supported staff through training, supervision and appraisal. Staff discussed the challenges and rewards they experienced while working with people. Staff reflected on and took action to improve their practice.
The principles of the Mental Capacity Act 2005 (MCA) were followed by the registered manager and staff. MCA training was made available for all care staff. People were supported to have maximum choice and control of their lives and staff provided care in the least restrictive way possible for people. The policies and systems in the service supported this practice.
Before care was provided staff obtained people’s consent to care and support. People made decisions about the care and support they were going to receive and staff respected these choices.
Meals provided met people’s needs and individual preferences. When people needed shopping staff completed this so people had access to food and drink to meet their needs.
People were supported by staff to meet their health care needs. Care and support was delivered in a flexible way which allowed people to make decisions on their care and support. End of life choices was recorded in people’s care records.
Staff displayed kindness and compassion while caring for people. Staff respected people’s dignity and promoted their privacy.
Infection control procedures were followed by staff. The registered manager provided personal protective equipment for staff to use to reduce the risk of infection.
People had assessments of their needs completed and they were encouraged to contribute to them. The registered provider had systems in place to ensure people had regular reviews of their care needs.
There was a system for people to complain about the care and support received. People were confident in making a complaint about the service.
There was an organisational structure in place at the service. The registered manager provided leadership to staff and supported staff so they were able to carry out their jobs.
The service had developed working partnerships with health care professionals in health and social care services.
You can see what action we told the provider to take at the back of the full version of the report.