Archived: Progress House

Progress House is registered to provide personal care and support to people living in their own homes. At the time of our inspection Progress House was providing personal care to 120 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Risk assessments required more individualised detail to ensure that care staff had clearer guidance on how risks were to be mitigated. Care plans also required more detail, particularly where people were living with dementia, had health conditions, or poor mental health.

The recording within medicines administration records was improved, but we found some discrepancies between what was written in the care plan, and what people were prescribed.

The majority of people told us that care staff were reliable, but sometimes they arrived later or earlier than agreed. They also reported that rotas which detailed who would be visiting them could change and they weren’t always advised of this.

The provider's governance systems had been effective at monitoring the quality of care in some areas but not all, resulting in issues not always being identified and therefore improved where required.

The majority of people we spoke with told us that the carers who visited them were kind and caring, and ensured they were treated with respect.

The provider had responded to the COVID-19 pandemic promptly, implemented policies in line with guidance and ensured all care staff had access to personal protective equipment (PPE). Systems were in place to protect people from the risk of abuse and avoidable harm.

There were sufficient care staff to cover all visits. The necessary checks had been made to ensure that care staff working at the service were of good character.

People's complaints were listened to and acted upon to improve the quality of care they received. However, some people told us that issues were still on-going in relation to changes to their rota and times of visits.

The service had an open and positive culture. Care staff felt supported and able to speak with the registered manager at any time.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 19 March 2019) and there were two breaches of regulation. The service remains rated requires improvement. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made in some areas, however we found some repeated issues which meant the provider remains in breach of one regulation relating to good governance.

Why we inspected

We carried out an announced comprehensive inspection of this service on 13 and 18 February 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and governance systems.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of safe, responsive and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed and remains Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Progress House on our website at www.cqc.org.uk.

We have found evidence that the provider needs to make improvement. Please see the safe, responsive and well-led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We have identified breaches in relation to good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good.

People’s experience of using this service:

¿ People told us that care staff were kind and caring in their interactions with them. People told us that staff knew their needs well, and were reliable. Some people told us their calls were sometimes late, but they could rely on staff attending at each planned visit.

¿ People were not always protected against the risks associated with the unsafe management and handling of medicines. Documentation was poorly completed.

¿ Auditing processes had failed to identify issues with medicines documentation and administration which put people at risk of harm.

¿ Late visits were not being monitored by the management team to ensure that care was carried out in a timely manner.

¿ Further improvements were needed to ensure care plans and risk assessments were accurate and sufficiently detailed.

¿ There were sufficient staff to cover all visits. Recruitment procedures were in place to ensure staff were suitable for their roles.

¿ The principles of the Mental Capacity Act (2005) were adhered to.

¿ People were supported to eat and drink enough to maintain a balanced diet.

¿ People had access to healthcare professionals when required.

¿ Staff knew how to care for people and received training in their roles, and support from the registered manager.

¿ The registered manager was open and transparent and welcomed feedback from us. They demonstrated a commitment to putting systems in place which would promptly address the issues we found.

¿ We found the service had deteriorated and met the characteristics of a ‘Requires Improvement’ rating in safe, responsive and well-led. This meant the overall rating was ‘Requires Improvement.’

Rating at last inspection: At the last inspection the service was rated Good (Report published June 2016).

Why we inspected: We inspected this service in line with our inspection schedule for services currently rated as Good.

Enforcement: Action we told the provider to take is outlined at the back of the report.

Follow up: We will continue to monitor this service according to our inspection schedule in line with the rating of ‘Requires Improvement.’

Progress House is registered to provide personal care and support to people living in their own homes. At the time of our inspection Progress House was providing support to 80 people.

There was 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. We were told that the manager was new to the post and was in the process of submitting their registration documents.

Staff knew how to recognise and report any concerns so that people were kept safe from the risk of abuse. People who needed support were assisted to safely use medicines. There were enough staff to enable all of the planned visits to be completed on time. Background checks had been completed before new staff had been appointed.

Staff knew how to care for people in order to meet their needs and they had received all of the training and support they needed. People had been supported to eat and drink enough and to access any healthcare services they needed.

The registered manager and staff were following the Mental Capacity Act 2005 (MCA). This law is intended to ensure that people are supported to make decisions for themselves. When this is not possible the Act requires that decisions are taken in people’s best interests.

People and their relatives said that staff were kind and caring. Staff recognised people’s right to privacy, promoted their dignity and respected confidential information.

People had been consulted about the care they wanted to receive There were arrangements in place to quickly and fairly resolve complaints.

Regular quality checks had been completed and people had been consulted about the development of the service. The service was run in an open and relaxed way, there was good team work and staff were supported to speak out if they had any concerns about poor practice. People had benefited from staff acting upon good practice guidance.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People were cared for by staff who were supported to deliver care and assistance safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people received. Appropriate systems were in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and of care staff.

There was a generally effective complaints system available with comments and complaints people made being responded to appropriately. However some people who we talked with said that they had complained, without success, about visits being late and about not being notified about changes to the care staff visiting them.

People we spoke with felt involved in planning their care package. The manager visited people in their home to carry out an assessment of their needs before care was provided.

We looked at six care plans. We saw that these were fully completed and contained personal details, care assessments, risk assessments, care plans and care worker visit reports. The care needs of the individual were clearly identified in the care plan.

The service carried out robust quality assurance checks and used these to monitor and improve the service provided