Archived: Siddeley House

Siddeley House is a domiciliary care agency. It provides support and personal care to people living in their own houses and flats.

The Care Quality Commission (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. At the time of the inspection 44 people using the service were receiving personal care.

People’s experience of using this service and what we found

At the last inspection the service provided was not always safe for people to use as people’s support visits were not always occurring at the agreed time or lasting for the agreed duration. The care provided was not always effective as some people and their relatives thought the difference in the quality of skill sets of individual staff members, showed a need for training more focussed on the needs of individual staff. The service was not always well-led as the quality assurance system did not always identify and address people's concerns about the service delivered.

At this inspection people and their relatives said that calls were taking place on time and lasting for the agreed duration. People were informed if staff were running late. There were enough staff who were appropriately trained and provided care and support in a friendly way. The quality assurance system identified and addressed people's concerns about the service.

People received a safe service with risks to people assessed, monitored and reviewed. This enabled the provider and staff to minimise risks to people. There were enough appropriately recruited staff. Accidents, incidents and safeguarding concerns were reported, investigated and recorded. Medicines were safely administered by trained staff. Personal Protective Equipment (PPE) was available and current guidance followed. The infection prevention and control policy was up to date.

The service was effective with peoples’ needs assessed, and they were given choices, as to when and how they would receive care and support. Staff encouraged them to discuss their health needs, any changes to them and they were passed on to appropriate community-based health care professionals. Staff received appropriate, good quality training. The provider was part of a professional’s network promoting joined up working between services based on people’s needs, wishes and best interests. This included any required transitioning of services if people’s needs changed. Staff protected people from nutrition and hydration risks, and they were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences.

The service was well-led with quality regularly reviewed, and changes made to improve the care and support people received. The provider had a culture that was positive and open, with an identifiable leadership and management structure. The provider’s vision and values were clearly set out, staff understood them and were aware of their responsibilities and accountability. The provider established working partnerships to promote the needs of people being met outside its remit to reduce social isolation. Registration requirements were met.

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; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 16 September 2022) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contained those requirements and a recommendation. A decision was made for us to inspect and examine the risks associated with these issues.

CQC has introduced focused inspections to follow up on previous breaches and to check specific concerns.

As no concerns were identified in relation to the key questions Caring and Responsive, we decided not to inspect these questions. Ratings from the previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Siddeley House on our website at www.cqc.org.uk.

Siddeley House is a domiciliary care agency. It provides support and personal care to people living in their own houses and flats.

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

At the last inspection the service provided was not always safe for people to use as people’s support visits were not always occurring at the agreed time or lasting for the agreed duration. The care provided was not always effective as some people and their relatives thought the difference in the quality of skill sets of individual staff members, showed a need for training more focussed on the needs of individual staff. This meant people were not always receiving the care and support they needed, when they needed it. The service was not always well-led as the quality assurance system did not always identify and address people's concerns about the service delivered. This meant their needs were not always met. We also recommended that the provider revisit the training it provides for staff.

At this inspection some people and their relatives said that calls were still not taking place on time and lasting for the agreed duration. This meant not all people using the service were receiving the care and support they needed when it was required. Others told us that calls were now happening on time and for the full duration. There were enough appropriately recruited staff who generally provided care and support in a friendly way. People had risks to them assessed, monitored and reviewed. This helped to minimise risks to them. Accidents, incidents and safeguarding concerns were reported, investigated and recorded. Medicines were administered by trained staff.

At this inspection staff training shortfalls had been addressed. This meant staff were better trained to meet people's needs. People's needs were assessed, and they were given choices. They were encouraged by staff to discuss their health needs, any changes to them and they were passed on to appropriate community-based health care professionals. The provider was part of a professionals network that promoted joined up working between services based on people’s needs, wishes and best interests. This included any required transitioning of services as people’s needs changed. People were protected by staff from nutrition and hydration risks, and they were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences.

At this inspection the quality assurance (QA) and care planning system identified shortfalls in care planning. However, some people were still not receiving their calls on time and for the full duration. This meant not all people using the service were receiving the care and support required when they needed it. Although service quality was regularly reviewed, the changes made to improve the care and support people received were not reflected by people always getting the care and support they needed. The provider’s culture was open, and positive with identifiable leadership and management. The provider’s vision and values were set out, staff understood them and were aware of their responsibilities and accountability. The provider established working partnerships to promote the needs of people being met outside its remit to reduce social isolation. Registration requirements were met.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 23 February 2022) and there were multiple breaches of regulation.

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

The service remains rated requires improvement.

At this inspection we found the provider remained in breach of regulations 17 (Good Governance) and 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements and a recommendation. A decision was made for us to inspect and examine the risks associated with these issues.

Care Quality Commission (CQC) has introduced focused inspections to follow up on previous breaches and to check specific concerns.

As no concerns were identified in relation to the key questions Caring and Responsive, we decided not to inspect these questions. Ratings from the previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Siddeley House on our website at www.cqc.org.uk.

Enforcement

At this inspection we have identified breaches in relation to people not receiving calls at the agreed times, and lasting the full duration, placing people at the risk of harm and the quality monitoring system not effectively addressing people’s concerns regarding this.

Please see the action we have told the provider to take at the end of this report. Full information about CQC's response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Siddeley House is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

The Care Quality Commission (CQC) only inspects the service being received by people provided with ‘personal care’; 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

The service was not always safe as some people using the service, their relatives and a health care professional had raised concerns regarding calls not taking place at the agreed time and for the agreed duration.

Some people and their relatives told us the care provided was not always effective. They thought the difference in the quality of skill sets of individual staff members, showed a need for training more focussed on the needs of individual staff. Some staff were described as very skilled, whilst others were not.

The service was not always well-led as the quality assurance system did not always identify and address people's concerns about the service delivered.

Staff were appropriately recruited with required checks carried out. People and staff had risk assessments, that were monitored and updated when required. Accidents, incidents and safeguarding concerns were reported, investigated and recorded. Medicines were safely administered. The service met shielding and social distancing rules, used Personal Protection Equipment (PPE) effectively and safely and the infection prevention and control policy was up to date.

People had not experienced discrimination and their equality and diversity needs were met. Staff received supervision, and appraisals. The people using the service and relatives we contacted, said the way staff provided care met their needs although some better than others. Staff encouraged people to discuss their health needs and these were passed on to appropriate community-based health care professionals. The provider had developed a professional’s network that enabled joined up working between services based on people’s needs, wishes and best interests. This included any services that required transitioning as people’s needs changed. Staff protected people from nutrition and hydration risks, and people were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences.

Most people and their relatives said they received care and support from staff in a friendly way, although some felt that some staff carried out tasks with little interaction. This depended on individual staff and how well-established they were with people. People said those that were well established paid attention to small details making all the difference. Staff respected and acknowledged people’s privacy, dignity and confidentiality. People were encouraged and supported to be independent and do things for themselves, whenever possible. This improved their quality of life by promoting their self-worth. Some staff were very caring, compassionate and passionate about the people they provided a service for, whilst others were less committed.

The service was responsive with people’s needs assessed, reviewed and care plans in place including any communication needs. Person-centred care was provided. People were given choices, encouraged to follow their routines, interests and hobbies so that social isolation was minimised. People were given enough information to make their own decisions. Complaints were recorded and investigated.

The provider had transparent management and leadership with an open culture that was honest and positive. The statement of purpose clearly defined the provider vision and values, that staff understood and followed. Staff were aware of their responsibilities, accountability and mostly were willing to take responsibility and report any concerns they may have. The provider reviewed the quality of the service people received. The provider had well-established working partnerships that promoted people’s needs being met outside its remit to reduce social isolation. Registration requirements were met.

Why we inspected

This service was registered with us on 27/05/2020 and this is the first inspection.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk