The inspection took place on 23rd September and was announced. The provider was given 48 hours' notice because the location provided a domiciliary care service and we needed to be sure that someone would be in. I&S Care is a domiciliary care agency that provides personal care and domestic support to people in their own homes. At the time of inspection there were nineteen people using the service.The service has 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.
At this inspection we found the service to be in breach of Regulations 12, 17 & 19 of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
Improvements were required in the safe management of medicines to ensure people received their medicines as prescribed and any errors were identified and addressed.
There was a system in place for the safe recruitment of staff but this was not always adhered to. This meant that the necessary checks were not always completed for all staff.
The provision of formal training was patchy and inconsistent with no structured training programme in place. The registered manager did not have systems to monitor gaps in staff training.
Staff received informal supervision and appraisals on an ad hoc basis. There was no formal systems and processes in place to ensure that staff were supported with their professional development and monitored to ensure their competency so that they could meet people’s needs safely and effectively.
There was a lack of quality assurance mechanisms in place to monitor the safety and quality of the service and to drive improvements.
People were protected from abuse as staff knew what constituted abuse and who to report it to if they suspected it had taken place.
There were sufficient numbers of staff to meet peoples care and support needs and keep them safe.
The service understood how to manage risk in a way that kept people safe whilst respecting people’s rights and freedom to exercise choice and control.
The Mental Capacity Act 2005 (MCA) is designed to protect people who cannot make decisions for themselves or lack the mental capacity to do so. The provider followed the principles of the MCA by ensuring that people consented to their care or were supported by representatives to make decisions.
People were supported to have enough to eat and drink and to access health care services to maintain their health and wellbeing. When people became unwell staff responded quickly and sought the appropriate support.
Care workers had very positive relationships with people who used the services and were valued and held in high regard by people and the families they supported. The care delivered was personalised and met people's individual needs and preferences.
People, or their representatives, where appropriate, were involved in how their care and support was delivered so felt listened to and included. Care workers treated people with dignity and respect and promoted people’s independence.
The provider had a complaints procedure in place and people who used the service knew how to use it.
Staff told us that they were well supported by the management team and felt confident that any concerns they raised would be listened to and dealt with fairly.