Background to this inspection
Updated
7 April 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 1 February 2017 and was announced. The inspection was to follow up concerns identified at our last inspection and in response to information we received which indicated potential concerns about the management of risks. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to ensure that there would be someone available to give access to care records for review had we required them. The inspection team consisted of two inspectors who visited the service’s office. The inspection team also included an expert by experience who spoke to people who used the service on the telephone. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.
Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Due to technical problems a PIR was not available and we took this into account when we inspected the service and made the judgements in this report.
We checked if the provider had sent us any notifications since our last visit. These contain details of events and incidents the provider is required to notify us about by law, including unexpected deaths and injuries occurring to people receiving care. We reviewed any additional information we held or had received about the service. We reviewed a plan of actions the registered provider had told us they intended to take in order to address our concerns from the last inspection .We used this information to plan what areas we were going to focus on during our inspection.
During our inspection we spoke to the nominated individual for the service who was also the registered manager. We spoke with the deputy manager, a new care manager who was applying to become the new registered manager for the service, two care coordinators, one team leader, two members of care staff and two administrative staff. We looked at records including the care plans of eight people and medication records of three people who used the service. We looked at six staff files and staff training and recruitment records to identify if staff had the necessary skills and knowledge to meet people’s care needs. We looked at the provider’s records for monitoring the quality of the service to see how they responded to issues raised. We reviewed how the service was responding to concerns raised by two local authority’s which had resulted in them suspending the commissioning of new care packages from the service.
Updated
7 April 2017
The inspection took place on 1 February 2017 and was announced. Passion 4 Care provides personal care to people in their own homes. At the time of our inspection 221 people were using the service.
There was a registered manager in place who was present during our inspection. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was also the nominated individual for the service.
We last inspected this service in July 2016 and found that the provider was breaching five of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We had found that the provider had failed to ensure that actions were taken to safeguard people in line with the local safeguarding policy and procedures. There was no effective system in place for receiving and responding to all complaints received. Recruitment processes had not ensured that people were supported by staff who had been assessed as suitable. The inspection rating awarded previously was not conspicuously displayed on their website. We also found that the systems used to assess, monitor and improve the quality and safety of the services provided to people and the managements of risks to people was not effective.
At this inspection we found that improvements had been made to the provider’s safeguarding, complaints and recruitment processes and they had taken effective action to display their latest ratings. However the registered provider had failed to make sufficient improvement to assess, monitor and improve the quality and safety of the service. The registered provider did not have a clear and concise staff rota system so they could monitor if people were receiving their calls as planned. They did not provide detailed guidance for staff about the risk associated with people’s conditions. Systems in place did not always ensure the registered provider responded appropriately to requests for information from the commission.
People told us they felt the service kept them safe and felt confident in the abilities of the staff who supported them. The registered provider had taken action to ensure concerns about people being at risk of abuse would be raised with the appropriate authorities and in line with good practice.
People were supported by staff who involved other health professionals when their conditions changed so that people were supported by the most suitable health care professional to meet their needs.
Staff were knowledgeable about how to protect people from the risks associated with their specific conditions but this detail was not always reflected in people’s care plans for use by staff who were less familiar with people’s needs.
People told us they were happy with how staff supported them with medication; however records were not always sufficiently completed to demonstrate that people had received their medication as prescribed.
People were happy to use the service and felt supported by consistent staff who had the skills and knowledge to meet their individual care needs. The registered provider had taken action to ensure people were supported by staff who were suitable to do so.
People were supported to express how they wanted their care to be provided and were supported in line with the Mental Capacity Act 2005. Staff knew people’s individual preferences and how to maintain their privacy and dignity when providing personal care.
People and staff told us they felt comfortable to complain if something was not right and they were confident that their concerns would be taken seriously. The registered provider had taken action to improve how people’s complaints were handled.
People expressed confidence in how the service was run and leadership. Most people told us that the quality of the service was improving.
The registered provider had taken action to improve how they managed the service including employing a care manager and installing an electronic quality monitoring system. However further action was required to fully commission the system.