Background to this inspection
Updated
15 April 2016
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 2 and 25 February and 2 March 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service; we needed to be sure that someone would be in the office.
The inspection was carried out by one adult social care inspector.
Before the inspection we reviewed other information we held about the service and the provider. This included previous inspection reports and statutory notifications we had received from the provider. Notifications are changes, event or incidents the provider is legally obliged to send to CQC within required timescales. We also contacted the local Healthwatch, the local authority commissioners and safeguarding team for the service and the clinical commissioning group (CCG). Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
We visited four people who used the service and spoke to three relatives. We also spoke with the registered manager, the supporting manager, deputy manager, one care co-ordinator, the training co-ordinator and four members of staff. We sent questionnaires to six care workers and received two responses. We looked at the care records for nine people who used the service, medicines records for four people and recruitment records for six staff.
Updated
15 April 2016
The inspection took place on 2 and 25 February and 2 March 2016 and was announced. The service was last inspected in December 2013 and met the regulations we inspected against at that time.
Sunderland Home Associates (SHCA) is an employee owned social enterprise that is registered with the Care Quality Commission for the regulated activity of personal care. The service provides domiciliary care for people in Sunderland.
The service had a registered manager. 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the time of the inspection the registered manager was not actively managing the service. A registered manager from another location was supporting the deputy manager in the day to day management.
The registered provider had breached regulations 9, 12 and 17 of the Health and Social Care Act 2014. You can see what action we told the provider to take at the back of the full version of the report.
We found that people’s care plans did not always contain accurate information on how to support them. Records held in the office were not always fully completed with documents lacking detail. Records in people’s homes also lacked up to date information. We found that even though spot checks had been completed and people’s reviews had been completed, these had not picked up changes in people’s needs.
We found that people’s care records did not contain up to date risk assessments. Records held in the office and in the community were not always fully completed. Risk assessments were not effectively reviewed and did not pick up changes in need.
We found that the processes the service had for assessing and monitoring the quality of record keeping was limited. The provider’s quality assurance process did not take into account a managerial oversight of the service in relation to the quality or effectiveness of care records.
The business continuity plan was dated 2011 and did not contain up to date contact information. There was no evidence to demonstrate the plan had been reviewed.
Relatives and people were happy with their care. One person told us, “We are very happy with the care they give us.” Another commented, “The male carers are brilliant.” One relative told us, “They look after [family member] they are magnificent with them.” Another relative commented, “They are very good and always arrive on time, logging in and out.”
Relatives and people told us the service was safe. One relative said, “The care is safe, training with the hoist was done here. Staff follow the moving and handling plan that the local authority developed.” Staff knew how to contact other health care professionals when necessary and felt confident in doing so.
The registered provider operated a robust recruitment procedure which included ensuring appropriate checks were undertaken before staff started work. Staff had completed mandatory training required to perform their role. Training was up to date and refreshed as necessary. Staff received regular supervision and annual appraisals.
Staff said they were well supported and trained to carry out their caring role. One staff member said, “I am new to care and did extra shadowing until I felt confident.” Another staff member said, “We get a good amount of training, this is a brilliant organisation to work for.”
Staff had a good understanding of safeguarding and whistleblowing. Staff were able to describe the signs of potential abuse. Staff we spoke to had a clear understanding of what actions to take if they had concerns about a person’s safety or treatment. They were confident that any concerns would be listened to and investigated to make sure people were protected. One staff member said, “I would contact the office and report to the manager.” Another staff member said, “I would speak to the manager at any time I was concerned.”
Staff had an understanding of the Mental Capacity Act 2005 and Deprivation of Liberty and knew how support people with making day to day choices and decisions.
People were supported by a consistent staff team. One relative told us, “It is important to have consistency, we get a rota every week.” They went on to say, “Staff stay for the full-time and are generally on time.”
We saw that systems were in place for recording and managing safeguarding concerns, complaints, accidents and incidents. The service maintained a log of all safeguarding alerts which showed that appropriate action was taken.
Relatives and people knew how to complain if they were unhappy with their care. People we spoke with had not raised any complaints with the service. One relative said, “I have nothing to complain about.” The service logged complaints and compliments it received. Complaints received during 2015 had been investigated and the outcome recorded.
There were opportunities for staff members to give their views about the service, through attending team meetings and supervisions. One staff member said, “I attend regular team meetings.”
The service had a process in place to capture people’s views of the service along with relatives. We saw positive feedback had been received following the most recent consultation with people using the service.