Archived: Palmerstone Homecare

Updated 30 September 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 between 12 July and 20 July 2016 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in.

The inspection team consisted of one inspector. We reviewed information we held about the provider including concerns reported to us. This is where one or more person’s health, wellbeing or human rights may not have been properly protected and they may have suffered harm, abuse or neglect.

We accompanied staff from the agency on visits to one person who was in receipt of care. We also spoke on the telephone to 16 people, which included people who received care and their relatives. We spoke with 13 staff including the head office team and the registered provider who was also the manager of the service

We reviewed a range of documents and records including care records for people who used the service, records of staff employed, complaints records, and incident records We looked a range of quality audits and management records

Updated 30 September 2016

This was an announced inspection carried out on the 12 and 13 July 2016. At the last comprehensive inspection in September 2015, we rated the service as requires improvement. At that inspection we found two breaches of regulation; people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines and people who use the service were not protected from the risks of unsafe care because the recruitment procedures were not adequate.

After the inspection in September 2015, the provider wrote to us to say what they would do to meet the regulations in relation to each breach. They told us they would complete all actions by the end of January 2016. At this inspection, in July 2016, we found that the provider had not completed their plan of action and legal requirements were still not met. We also found additional breaches.

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

Palmerstone homecare provides personal care and support to adults who live in their own homes. At the time of inspection up to 197 people were using the service and some people were vulnerable due to their age and frailty, and in some cases had specific and complex health care needs.

We completed this inspection after receiving concerns about missed and late visits and people being left without care and support. Concerns included people’s personal care needs not being met and people not receiving their medicines at the prescribed times. We found the local authority had temporarily suspended new placements to the service because they had concerns about the service being provided.

The service has a registered manager in post. 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.

Medicines were not managed safely. Safe medicine administration practices were not followed so people were not protected against the risks of unsafe management of medicines. Although some staff had received training in managing medicines, this had not given staff the required competency to manage medicines safely.

Sufficient recruitment checks had not been carried out before staff started work to ensure that they were suitable to work in a care setting. Staff were not always supported to carry out their work and had not received regular support and training.

The provider's systems to monitor and assess the quality of service provision were not effective. Actions that had been identified to improve the service were not always implemented and the provider's quality monitoring systems had failed to identify significant concerns. People did not always receive their care and support as planned as staff had missed some people's calls and did not always spend the agreed time on the calls.

There were not always effective systems in place to respond appropriately to complaints and comments made by people who used the service or people acting on their behalf. People who used the service were not confident that their comments and complaints were always listened to and dealt with effectively.

People were receiving the support they needed to eat and drink sufficient amounts to help meet their nutritional needs. Staff knew who to speak with if they had any concerns around people's nutrition.

Risk assessments identified specific risks to people and hazards in their home environment.

Staff had a good knowledge of safeguarding procedures and were clear about the actions they would take to help protect people. Risk assessments had been completed to help staff to support people with everyday risks and help to keep them safe.

People were supported by staff to maintain good healthcare and were assisted to gain access to healthcare providers where possible.