Collingwood Care Services

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.

Collingwood Care Services is a domiciliary care service which is set up in partnership with Highbury College and provides end of life care and personal care to adults, who live in their own home. At the time of the inspection there were five people using the service. People were not in receipt of end of life care. There were six care staff who delivered care to people along with the provider and the business manager.

The service was run by the registered provider, who also acted as the manager. 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 our last inspection in July 2016 we found the provider did not always follow safe recruitment and medicines practice. At this inspection we found safe recruitment and medicines practices had been followed.

At our previous inspection in July 2016 we found care plans in place did not contain information on how people would like their care to be provided and as a result the provider did not maintain accurate, complete and contemporaneous records. At this inspection we found the provider had partly met this regulation. Care plans were in place; however information relating to moving and handling support was not sufficiently detailed or accurate in people’s care plans.

At our last inspection in July 2016 we found the provider did not have audits in place to monitor the quality and safety of their service and they had not submitted a Provider Information Return (PIR) upon request. At this inspection we found the provider had met part of the regulation. The provider had submitted a PIR when requested, however audits continued to not be in place to monitor the quality and safety of their service.

Incident and safeguarding information was not recorded to help the provider assess the overall safety of the service.

Safeguarding concerns had not been received about the service; however staff and the provider knew what to do when safeguarding concerns had been identified.

There were enough staff to meet people’s needs and support them safely.

Staff were skilled and experienced to support people and knew them well. Staff received an induction when starting work at the service which covered recognised standards of care. Staff received updated training and supervisions.

Staff had an awareness of the Mental Capacity Act 2005 and how this related to people they supported. People did not lack capacity at the time of the inspection for decisions relating to the care they were being provided..

People were supported with food and drink when required and were supported to have access to external health and social care professionals when necessary.

Staff were caring and respected people’s privacy, dignity, preferences and independence.

People had individual care plans, were involved in their care planning and had choice and control over decisions about their care. Staff were punctual, there was good continuity of care workers and people were not rushed.

Complaints had not been received into the service. The service had displayed the rating from their previous inspection.

We found a breach of one Regulation 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 this report.

Collingwood Care Services is a domiciliary care service which is set up in partnership with Highbury College and provides end of life care and personal care to adults, who live in their own home. At the time of the inspection there were nine people using the service and seven people were receiving end of life care. There were eight care staff who delivered this service which included one team leader and two lead care workers. There was also a registered manager and a business manager who were also the provider of the service.

There was a registered manager in post at the time of the inspection. 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.

People felt they received safe care from staff and staff knew how to keep people safe. Risk assessments were in place to identify risks to people and provide guidance for staff on how to balance risks. Staff were aware of the importance of monitoring people’s skin integrity on a consistent basis at the end stages of their life. There were enough staff to meet people’s needs. However safe recruitment and medicine practices were not always carried out.

Staff were supported well and provided with training and supervisions to help them meet people’s needs. Additional training was provided to help support people in the end stages of their life. Although staff had not received training on Mental Capacity Act (MCA) 2005; staff demonstrated an understanding of their roles and responsibilities under MCA and could put them into practice to protect people. People receiving the service at the time of inspection did not lack capacity.

People were supported to receive healthcare services and were involved in decisions about their nutrition and hydration needs.

People and relatives were positive about the care and support received from staff. Both the registered manager and business manager knew people well and spoke about them in a kind, caring and respectful manner. Compliments had been received in the form of thank you cards and complimentary emails. People who were able to be involved in their care felt involved in their care and consented to this. Relatives were consulted about people’s care at the end of people’s lives because they were unable to communicate. People’s privacy and dignity was respected and promoted.

People’s needs were assessed and relatives were involved in the assessment of people’s needs when the person requested their involvement or when the person was at the end of their life and was unable to communicate their needs. People did not have a care plan stating how they would like their care to be provided. However people received care in the way that they wanted and were given choice. Complaints had not been received into the service.

People and staff had high praise for the registered manager and business manager. Notifications had been sent to the Commission. However the registered manager failed to complete and return their Provider Information Return when requested. Although feedback about the service had been sought recently from people and incidents and accidents had been analysed; audits to monitor the quality and safety of the service were not in place. Staff and people’s records were not always made available.

We found breaches in three regulations 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 this report.