Archived: Complete Care Services Blackburn

Updated 28 June 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was undertaken by one adult social care inspector. People who used the service were contacted via telephone by an expert by experience to understand their experience of using the service. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

This service is a domiciliary care agency. It provided personal care to people living in their own houses and flats. It is registered to provide a service to older adults, younger disabled adults, people living with dementia, learning disabilities, mental health, physical disabilities, sensory impairments and people who misuse drugs and alcohol.

The service had a manager registered with the Care Quality Commission. This means that they 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:

We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 21 May 2019 and ended on 22 May 2019. We visited the office location on both dates to see the care manager and office staff; and to review care records and policies and procedures. Phone calls to people who used the service and their relatives were made on 21 May 2019.

What we did:

Our inspection was informed by evidence we already held about the service. We also checked for feedback we received from members of the public, local authorities, Healthwatch, safeguarding and clinical commissioning groups (CCGs). We also checked records held by Companies House.

We asked the service to complete a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During inspection we spoke with five people who used the service and three relatives to ask about their experience of the care provided. We also spoke with the regional manager, care manager, and three care staff. We also attempted to contact two staff members by telephone but were unsuccessful. The registered manager was unavailable during the inspection due to annual leave.

We reviewed a range of records. This included, five people’s care records and five staff files around recruitment. We also looked at various records in relation to medication, accidents and incidents, complaints, training and supervision of staff, records relating to the management of the service and a variety of policies and procedures developed and implemented by the provider.

After the inspection, we met with the provider and accepted additional evidence.

Updated 28 June 2019

About the service:

Complete Care Services Blackburn is a domiciliary care agency that was providing personal care to 23 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

The service had not always appropriately managed risks to people's health and wellbeing and staff had not always undertaken training to address risks people presented with. Action was taken during the inspection to address this. Staff were working long shifts and reduced days off to ensure that care was delivered in line with care packages agreed, this resulted in staff morale being low. Recruitment systems and processes were not always robust. Medicines were not always managed safely.

Some staff had commenced the Care Certificate, although had not completed this within specified timelines in the company policy and procedure. None of the staff had received one to one supervision. Only two out of the five staff files we looked at had received a spot check to assess their competency in personal care. Staff had undertaken training in Mental Capacity Act, although two out of three staff were unable to tell us anything about it. We have made a recommendation about supporting staff through training and one to one supervision.

We saw complaints had been dealt with, but they did not identify if the desired outcome was achieved or if the outcome was satisfactory. We have made a recommendation about the management of complaints. The service was not always well-led. Staff described the morale as being low due to working over their normal hours due to staff shortages and felt unsupported by the management team. There was a lack of quality assurance systems and processes to monitor the service and drive improvements.

People told us they felt safe when staff were in their homes. Staff knew their responsibilities in relation to infection control. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported with their nutritional needs, where required and people told us staff would call a doctor if they were unwell.

We received positive comments from people about the caring nature of staff. Staff spoke about people in an extremely kind and caring way, expressing their passion for their role in supporting people. People told us staff communicated well with them and communication needs had been considered in care plans.

People confirmed they were able to contribute to their care plan and their opinions were considered. We found the majority of care plans were person-centred and contained detailed information to direct staff in their roles.

Rating at last inspection:

This was the first rated inspection since the service registered on 16 May 2018.

Why we inspected:

This was a planned inspection.

Enforcement:

We have identified breaches in relation to medicines, recruitment and governance at this inspection. Please see the action we told the provider to take at the end of this report.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.