Background to this inspection
Updated
5 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:
The inspection was completed by one Inspector.
Service and service type:
Care Never Sleeps is a domiciliary care service providing support to people living in their own homes and supported living accommodation. The service had a manager registered with the Care Quality Commission. This means 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 23 April 2019 and ended on 29 April 2019 We visited the office location on both days to see the manager and office staff; and to review care records and policies and procedures
What we did:
We reviewed information we had received about the service since they were registered with us. This included details about incidents the provider must notify us about, such as allegations of abuse and we sought feedback from the local authority and other professionals who work with the service. We assessed the Provider Information Return (PIR) we require providers to send this to us at least once annually, to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
We reviewed the care records of four people to see how their care was planned and delivered, as well as their medicine administration records. We looked at four recruitment, training and supervision records for staff. We also looked at records which supported the provider to monitor the quality and management of the service. We spoke with three people, two relatives and five staff. We received a letter from a person the agency was supporting. At the time of the inspection the agency was supporting seven people.
Updated
5 June 2019
About the service:
Care Never Sleeps is a domiciliary care service providing personal care to people living in their own homes. On the day of inspection, the agency was providing care to seven people. There was a registered manager in post.
People’s experience of using this service:
People told us they felt safe with the staff who supported them. People told us that staff were kind and considerate. Relatives spoken with told us that the staff were respectful. There were enough staff available to support people and calls were completed on time. People reported no missed calls, so people’s care needs were met.
The registered provider told us that people were not supported with their medication. We found that the medication administration records did not always reflect how staff supported people. Staff had completed training in the medication management that enable them to support people if required.
Risks associated with people’s care had been assessed to protect people from the risk of avoidable harm but were not updated with current risks when peoples needs changed..
Staff were aware of how to protect people from the risk of abuse and confirmed who they would report any concerns to, including external agencies if required. The registered manager ensured only suitable people worked at the agency. Recruitment checks were completed and included references and checks with the Disclosure and Barring Service. (DBS)
People confirmed the care they received met their individual preferences and choices. Care records although reviewed were not updated to ensure that accurate information was available.
There was a complaints procedure to enable people to make complaints and people spoken with were aware of these procedures. People told us they felt that the registered manager and staff would address any concerns they had.
People and their relatives told us that staff were very kind and caring and treated them with dignity and respect.
Rating at last inspection: The last inspection was completed on 28 February 2018 and was rated as requires improvement.
Why we inspected: This was a planned inspection.
Enforcement.
The evidence above showed that the provider was in breach of Regulation 17 of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014.
Following a local authority contracts monitoring visit in April 2019 the commissioners set out an action plan for the provider with specific areas for improvements. Because of their findings they stopped new referrals to the service of people funded by the local authority while the provider worked with them on an action plan to improve the service. This will be reassessed by the commissioning authority at their next visit as part of their service level agreement.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.