12 August 2014
During an inspection looking at part of the service
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
This is a summary of what we found. The summary describes the records we looked at and what people using the service, their relatives and the staff told us.
Is the service safe?
We found evidence people were not always protected against the risks associated with medicines because there were not appropriate arrangements in place to ensure medicines were managed safely. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to the management of medicines.
We found people were not always protected from the risks of unsafe or inappropriate care. We saw evidence the service had not always taken appropriate action to reduce risks for people. We also saw identified risks were not always supported by appropriate care plans to ensure people received safe and consistent care. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to the care and welfare of people who use the service.
Is the service effective?
The service had arrangements in place to ensure staff were trained and supported. This showed us people were being cared for by staff who were supported to deliver care and treatment to an appropriate standard.
We saw evidence people were not always receiving care and support at the times they required it. Seven of the eight people we spoke with said staff had been over an hour late for a call on at least one occasion in the past month. Five of these people said staff had not turned up at all for a call in the past month. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to the care and welfare of people who use the service.
Is the service caring?
Overall, people told us they were happy with the care and support staff provided. However, people said they did not always receive this support at the times they needed it. We found the care staff we spoke with demonstrated a good knowledge of people's needs and were able to explain how individuals preferred their care and support to be delivered.
Is the service responsive?
The provider had a process in place to deal with any complaints people made. However, we found evidence the service did not always follow this policy and deal with complaints effectively. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to complaints.
There was no formal system in place to ensure daily notes were regularly checked to ensure any changes in people's needs were quickly identified. From the records we reviewed we were also not always able to evidence that appropriate action had been taken when people's needs had changed. We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to assessing and monitoring the quality of service provision.
Is the service well led?
People provided feedback that the service was not well led. One person told us 'The service manager promises things, but then doesn't deliver them. I am not confident they know what's going on'. Another person said 'If you raise an issue you never know who is going to contact you; it could be someone from Hull; it could be someone from Chorley. It's confusing because I want someone based in Bradford to speak to me so they know my relative'.
We also saw evidence there were not effective systems in place to enable management to continually monitor and identify shortfalls in the service.
We have asked the provider to tell us how they will make improvements to meet the requirements of the law in relation to assessing and monitoring the quality of service provision.