This inspection took place on 14 March 2017 and was announced. Axis Recruitment Limited is registered to provide personal care and support to people living in their own homes. At the time of our inspection one person was using the service.
There was a registered manager in post. A manager is required to register with us by law. 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 (Regulated Activity) Regulations 2014 about how the service is run.
During our last inspection on 19 and 25 May 2016, we identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to; how risks were assessed and managed, the management of people’s medicines, the appropriate application of the Mental Capacity Act 2005, adult safeguarding procedures and staff training, how people’s preferences were assessed and recorded and the systems and processes in place to check on the quality and safety of the service. After the inspection the provider sent us an action plan to tell us what action they would take to meet these breaches in regulation.
During this inspection we checked to see whether improvements had been made. We found these breaches in regulation had been met. Some further improvements were required in some areas and the provider was taking action to address these areas.
Staff had received adult safeguarding training and had detailed information of the action required if they needed to report a safeguarding concern. New documentation had been completed that showed risks associated to people’s needs had been assessed and reviewed.
Sufficient staff were available to provide care and support as required. Safe staff recruitment checks were completed before staff commenced work. Improvements had been made to the management of medicines. However, further improvements were required. This was in reference to staff medicine competency assessments. The process of checking medicines received required two staff signatures but this was not happening.
Staff had received training before they commenced employment; the provider monitored when their refresher training was due and ensured this was completed as required.
New documentation had been complemented that showed consent had been sought about how care and support was provided. A policy and procedure for the Mental Capacity Act 2005 (MCA) had been implemented. Staff were clear about offering choices and respecting people’s wishes. Staff required MCA training, action was being taken to address this.
People were supported by staff to eat and drink, needs and preferences had been assessed and support plans introduced. New documentation had also been introduced that showed health needs had been assessed, planned for and monitored.
Action had been taken by the provider to introduce new support plan documentation that had been completed and reviewed with the involvement of the person using the service and their relative. This provided staff with detailed information of support needs, routines and preferences. A service user guide was available that provided information about what the service provided.
Feedback was received of how staff were kind, caring and respectful. Staff had good knowledge and awareness of individual needs, routines and preferences. Independent advocacy service information was not available but action was being taken to address this.
The provider’s complaint procedure was shared with people. Improvements had been made to the systems in place that monitored quality and safety. Positive feedback about the service was received and staff felt well supported. The provider had met their regulatory requirements.