Collingwood Care Services

Updated 10 August 2018

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.

This inspection took place on 14 and 15 May 2018 and was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the provider is often out of the office supporting staff or providing care. We needed to be sure that they would be in.

Inspection site visit activity started on 14 May 2018 and ended on 15 May 2018. It included visiting one person and one relative of a person supported by the service, discussions with the registered provider, business manager and two members of staff, reviewing policies and procedures, reviewing care plans and other documentation related to the management of the service.

The inspection was carried out by one inspector. Prior to the inspection, information about the service was reviewed. The service had not submitted any notifications since the last inspection. Usually we ask providers to send us a Provider Information Return (PIR). This is information we request to provide some key information about the service, what the service does well and improvements they plan to make. However, we decided to inspect the service before the PIR was requested.

We looked at five care plans and their associated risk assessments. We received information about the service from the local authority and West Hampshire Clinical Commissioning Group. We also contacted the community nursing team and a healthcare professional but did not receive any further information about the service.

Updated 10 August 2018

This inspection took place on the 14 and 15 May 2018 and was announced. A comprehensive inspection was completed to assess all of the key questions.

At the last inspection in July 2017 there was a breach of legal requirements in relation to good governance. It was found that the provider did not maintain accurate records in respect of each service user. The provider also did not have a system and process in place such as regular audits of the service provided to assess, monitor and improve the quality and safety of the service. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to meet the Regulation. The provider submitted an action plan but at this inspection we found the actions were not completed and the provider continued to be in breach of this Regulation.

Collingwood Care Services is a domiciliary care agency that operates from within the campus of Highbury College and provides personal care to people in their own homes in the community. It is registered to provide a service to older people and younger adults living with dementia, physical disability and sensory impairment. At the time of the inspection the service was supporting five people. There was an individual registered provider in place who also acted as the manager, there was no requirement for a registered manager at the service. Registered providers 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.

The provider had not ensured that quality assurance systems and processes such as audits were fully in place to monitor, assess and improve the service. The provider was not appropriately documenting, assessing and monitoring risks to the health, safety and welfare of people using the service.

The provider was not maintaining comprehensive and accurate records in relation to each service user. Information in the manual handling risk assessments was not consistent and sufficiently detailed to effectively inform staff members how to support people to move safely. People's diverse needs were not always well documented in their care plans.

There were gaps in the employment history of some staff records. Though the provider was aware of the reasons for any gaps, they had not documented them. Other recruitment checks such as Disclosure and Barring Service (DBS) checks were completed.

The amount of training staff received was variable and not sufficient to support service users effectively. The training matrix was not up to date and had multiple gaps. New members of staff were not completing the Care Certificate. The Care Certificate standards are nationally recognised standards of care which staff who are new to care are expected to adhere to in their daily working life to support them to deliver safe and effective care. We recommend that all staff complete the Care Certificate to ensure they are meeting the industry standard.

The provider and staff were not able to tell us any best practice guidance that they were following.

The provider told us that staff received training on how to support people in relation to the Mental Capacity Act (MCA) 2005 but it was not documented on the training matrix that staff had completed this training. There were not any individuals who required support in line with the MCA at the time of the inspection.

You can see what action we told the provider to take at the back of the full version of the report.

The provider told us there had not been any incidents, accidents, safeguarding concerns or complaints since the last inspection. We had not received any notifications about these type of events. A notification is information about important events which the provider is required to send to us.

People felt safe and staff knew people well.

Staff knew the signs of abuse and how to raise concerns about safeguarding.

Staff told us that they felt well supported by the registered provider and had supervisions arrangements in place.

There were sufficient numbers of staff in place to support people.

The service had policies in place to protect individuals from discrimination. People and staff said they had not experienced any discrimination.

Staff were caring and treated people with dignity and respect. Staff gained consent from people before supporting them.

We saw evidence that staff raised concerns about medical needs and referred people to healthcare professionals.

The service was not supporting people to take any medication at the time of the inspection.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.