8 March 2018
During a routine inspection
People using the service lived in flats and houses on one site in Mansfield, Nottingham. Other people who did not receive personal care services, also lived on the site.
An assessment unit was in place for up to twelve people. These people were staying temporarily at the unit. Their health needs and ability to care for themselves were assessed, with decisions made whether they could return home or needed to move to a residential service. The responsibility for caring for these people was shared between staff employed by Mears Care Limited and the Local Authority. Mears Care Limited staff were only permitted to support people with the regulated activity of personal care.
A registered manager was present during the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
Poppy Fields supported 48 people who received some element of support with their personal care. This was the service’s first inspection under its current registration.
People medicines were not always safely managed. Protocols for the administration of ‘as needed’ medicines were not always in place. Staff did not always ensure people’s medicines were stored safely and the process for the ordering of people’s medicines was not clear. Risk assessments in relation to people’s health needs were in place but these were not always completed in a timely manner. Staff raised concerns that they did not always have sufficient numbers in place at the assessment centre to meet people’s needs. On the day of the inspection we saw there were sufficient staff in placed. People living at Poppy Fields felt there were enough staff in place to support them. Safe recruitment processes were in place. Staff were aware of how to reduce the risk of the spread of infection. When incidents occurred, they were investigated and reviewed to ensure the chance of reoccurrence was reduced.
Best practice guidelines were not always in place to enable staff to support people with identified conditions. Staff spoken with raised some concerns that they were not always involved in the assessment of people prior to their admission to the assessment centre. This meant staff felt that they may not be able to meet some people’s needs. People were supported with maintaining good nutritional health. People had access to other external health and social care agencies. 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 support this practice. Staff were well trained and their performance was monitored.
People liked the staff and felt they were kind and caring and treated them with respect. Staff treated people with dignity and ensured they received their care and support in the way they wanted. People felt staff responded to their wishes and respected their choices. People’s diverse needs were respected. People were provided with information about how they could access independent advocates.
People’s care records contained detailed information about how they wanted to be supported. People told us staff cared for them in the way they wanted them to. This included them receiving support from their preferred staff. When Poppy Fields staff identified a concern with people’s health they ensured the staff employed by the Local Authority were informed to ensure people received the care they needed. The majority of people’s care plans were written in good time after their initial assessment. People’s needs were met without discrimination. People felt able to make a complaint and were confident it would be dealt with appropriately.
The registered manager currently manages two registered services. This meant their time was split between Poppy Fields and another service within the provider’s group of services. We had concerns that a service as complex as Poppy Fields did not have a registered manager assigned to oversee it on a full time basis. The quality assurance processes that were in place had not identified the concerns raised in this report. People and staff liked the registered manager, however many told us they did not see them very often. Staff felt valued and many people using the service would recommend the service to others. Notifiable incidents were reported to relevant agencies, although a small number of these needed to be reported quicker. People and staff felt able to give their views about how the service could be developed and improved.
We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the back of this report.