Background to this inspection
Updated
14 January 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection team consisted of two inspectors.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service did not have a manager registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 13 November 2019. We visited the office location on 13 November 2019 and carried out home visits for people using the service on 13 November 2019 and 15 November 2019. Telephone calls with staff were undertaken on 15 November 2019 and 19 November 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, local safeguarding team, commissioners for people using the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make.
This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service and one relative about their experience of the care provided. We spoke with eight members of staff including the branch manager, quality and compliance manager, carers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included four people’s care records and multiple medicine records. We looked at three staff files in relation to recruitment and staff supervision. We also looked at records that related to the management and quality assurance of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at peoples and staff care rosters, peoples call monitoring data and safeguarding records.
Updated
14 January 2020
About the service
Your Care and Support Northampton is a domiciliary care agency providing personal care to people living in their own homes.
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. At the time of inspection, 61 people were receiving support with personal care.
People’s experience of using this service and what we found
People’s risks had been assessed, however the provider did not have plans in place to mitigate all risks identified or provide enough guidance for staff to ensure people were supported safely.
There was not always enough staff to meet the needs of people using the service. People had frequently experienced late and missed calls and were at risk of neglect where care had not been provided.
We found gaps in medicine records and we could not be assured people were receiving their medicines as prescribed.
People were not always supported with eating and drinking. Visits to support people with preparing meals and drinks had been missed, this had also affected people that needed to take their medicines with food.
Systems and processes in place were not effective in identifying areas where improvements were needed within the service. Audits and quality assurance tools were not robust enough to drive improvement or provide enough oversight of the service.
People did not feel complaints were always acted upon. The provider had acknowledged this and had prioritised their focus on resolving issues and concerns raised.
Staff were not always receiving supervision or competency checks to support them in carrying out their role effectively. Staff told us how inconsistencies in communication from management and pressures on staffing had affected staff morale. Some improvement had been made, however this was not yet consistent or embedded into the service.
Staff were aware of how to identify and report any signs of abuse to safeguard people from harm.
People were supported by staff that were recruited safely and had received mandatory training as part of their induction to support their role.
People were supported to have maximum choice and control of their lives and staff supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The provider was in the initial stages of implementing changes to improve service delivery, following recent concerns raised. Actions had been taken and were ongoing to recognise changes needed, to support staff and to improve people’s experience of care. This was not yet embedded into the service to demonstrate its effectiveness.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 13 September 2018).
Why we inspected
We received concerns in relation to the management of the service, staffing, missed or late calls, outdated care plans and missed medicines. As a result, we undertook a focused inspection to review the Key Questions of Safe, Effective and Well-led only.
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 changed from Good to Requires Improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the Safe, Effective and Well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Your Care and Support Northampton on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment, meeting nutritional and hydration needs of people, staffing and 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 for 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.
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