8 November 2018
During a routine inspection
This was our first inspection of this service.
There was a registered manager in post. A registered manager is person who has registered with the 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.
People told us they received safe care. Staff told us they had been recruited safely although documentation to support this was not always present. Staff were aware of how to safeguard adults at risk although risk assessments had not been completed to direct staff. There was not always safe processes in place for the management and administration of medicines.
Audits and checks of the service were not completed regularly. We found the checks completed were ineffective in ensuring that appropriate levels of quality and safety were maintained at the service.
Care records documenting people’s needs and preference were absent. Risk assessments documenting and directing staff how to minimise the risk when supporting people were absent.
People receiving support and their relatives told us staff visited them mostly on time and stayed as long as they should. They liked the staff who supported them and told us they were usually supported by staff they knew. Although agency workers covered most of the shifts, it was usually the same agency workers that visited people.
Staff received an induction and appropriate training. However, we found some gaps in training for some staff. People receiving support and their relatives felt that staff were competent and had the knowledge and skills to meet their needs.
People mostly received appropriate support with eating, drinking and their healthcare needs. Referrals were made to community health and social care professionals to ensure that people’s needs were met.
People told us staff respected their right to privacy and dignity. They told us staff took their time when providing support and encouraged them to be independent.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice. Where people lacked the capacity to make decisions about their care, the service had taken appropriate action in line with the Mental Capacity Act 2005.
We saw evidence that people usually received care that reflected their needs, risks and preferences. People told us their care needs had been discussed with them in the past although staff were not always aware of changes in people’s needs. Initial assessments had not been completed with people prior to support being offered.
People being supported and their relatives told us they were happy with how the service was being managed. They found the registered manager and staff approachable and helpful.
Staff felt well supported and fairly treated by the registered manager and the provider.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, namely Regulation 12, Safe care and treatment and Regulation 17, Good governance. You can see the action we told the provider to take at the back of the full version of this report.