Archived: PiCAS

Updated 12 April 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 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.

This inspection took place on 10 February and 3 March 2016. The provider was given 48 hours’ notice because the location provides a supported living service in people’s own homes and we needed to be sure that someone would be available to assist with the inspection. The inspection was carried out by one inspector.

The service met the regulations we inspected at their last inspection which took place on 14 August 2015 and was rated as good.

During our inspection we met four people who used the service and talked with one of them. We spoke with four members of staff, the care coordinator and the registered manager. We looked at four people’s care records and other records relating to the service. This included recruitment, training and medicines records.

After the inspection we received feedback from six health and social care professionals and three relatives.

Updated 12 April 2016

This inspection took place on 10 February and 3 March 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service in people’s own homes and we needed to be sure that someone would be available to assist with the inspection. The provider has now moved office and their new address is 221 Aldborough Road South, Ilford, Essex, IG3 8HZ.

PiCAS is registered to provide personal care to people their own homes. At the time of the inspection they were providing a supported living service to 12 people. Supported living is where people live in their own home and receive care and/or support in order to promote their independence. Some people lived in a house that they shared with another person who used the service but most people lived on their own.

The service has 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 and associated Regulations about how the service is run. The registered manager is also the registered provider.

We found that the quality of the service provided varied between different supported houses.

Relatives were happy with the quality of care and felt that people had benefitted from the service provided to them. One relative told us that the service was marvellous. However, feedback from some health and social care professionals was that the service needed to improve to ensure people were supported safely in ways that met their needs.

Although people were encouraged to make choices and to have as much control as possible over what they did and how they were supported, systems were not in place to ensure that their human and legal rights were protected.

People did not consistently receive a safe service. Systems were not in place to ensure that people were protected from the risk of abuse. This was because although incidents were recorded they were not reported to the placing authority, to the local authority safeguarding team or to the Care Quality Commission.

The systems for staff summoning assistance in the event of an incident or emergency were not robust enough. We have recommended that these be reviewed and changed to ensure that help can be summoned when needed.

Systems were in place to ensure that people received their prescribed medicines safely and appropriately. Medicines were administered by staff who were trained to do this.

Staffing levels were sufficient to meet people’s needs and to enable them to do be supported flexibly and in a way that they wished.

The staff team did not always receive the training they needed to ensure that they supported people safely and competently. We have recommended that the training programme be reviewed to ensure that staff receive all of the necessary training in a timely way.

People were protected by the provider’s recruitment process which ensured that staff were suitable to work with people who need support.

People were encouraged to develop their skills and to be as independent as possible. One person said, “Staff have motivated me. I do what I want to do.”

Systems were in place to support people with their nutritional needs. They were supported to shop and cook for themselves according to their ability.

The registered manager monitored the quality of the service provided and sought feedback from people about the service.

Staff told us that they received good support from the registered manager. They were confident that any concerns raised would be addressed. People who used the service and their relatives also felt able to talk to the registered manager and said that any issues were dealt with quickly.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and one of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.