12 July 2016
During a routine inspection
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.