About the service The Human Support Group Stoke is a domiciliary care agency providing personal care to 54 people some of which may have been living with dementia and physical health issues at the time of the inspection.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Risk’s to people were not always suitably assessed and planned for. For example, where people had diabetes, or was at risk of choking, there was no specific guidance in place for staff to follow. There was no guidance in place for staff to follow when people had ‘as and when required’ medication. This was a breach of regulation 12 (Safe Care and Treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Despite what we found people told us they felt safe and were happy with their regular carers but when they did not attend, their call times could vary, which caused frustration for people. Staff were safely recruited, and people were protected from the risk of cross infection. The service had systems and processes in place to safeguard people from the risk of potential abuse.
Governance systems were not established or used effectively to ensure people received good quality care. This was a breach of regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider worked in partnership with others and the regional manager was aware of their duty of candour.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; however, the policies and systems in the service did not support this practice.
People had their needs assessed, however, support plans lacked detail on how to effectively support the person in line with their support needs. Staff did receive training in their role, however the service said it supported people with a range of different support needs and training provided did not cover these areas. Although guidance for staff was lacking for people who had dietary requirements, people told us they were happy with the way staff supported them.
People’s end of life wishes were not recorded. This meant people may not be supported in line with their wishes or preferences. Care plans did not consistently identify people’s preferences, however when people did receive their regular carers people felt staff knew them well. The service was meeting people’s communication needs and had a complaints policy in place.
People were supported by caring staff and were supported to express their views in making decisions about their care. People’s dignity was respected, and their independence promoted.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 22 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to safe care and treatment and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.