Background to this inspection
Updated
5 January 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 16 November 2017 and was announced. The provider was given 48 hours’ notice of our inspection because the service provides care to people in their own homes and we needed to be sure someone would be in at the office.
One inspector conducted the inspection on both days.
Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at this information together with other information we held about the home. We also received feedback from health care professionals that we used to help inform our inspection planning.
Information from a variety of sources was also gathered and analysed. We spoke with the local authority and Clinical Commissioning Groups responsible for commissioning care to check if they had any concerns.
We reviewed information held upon our database in regards to the service. This included notifications submitted by the provider relating to incidents, accidents, health and safety and safeguarding concerns which affect the health and wellbeing of people.
Information was gathered from a variety of sources throughout the inspection process. We visited the office and spoke with eight members of staff. This included the area manager, interim service manager, a senior care coordinator, administrator and four members of staff who provided direct care.
We visited four people at their home (with their and their relative’s consent) to seek their opinion of the service. We also spoke with three relatives to obtain their views about service provision.
To gather information, we looked at a variety of records. This included care files relating to four people who used the service and medication administration records relating to four people who received support from staff to administer their medicines.
We reviewed past and present staff rotas, focussing on how staff provided care within a geographical area. We also looked at how many visits a staff member had completed per day. We looked at the continuity of support people received.
We viewed recruitment files of six staff members and other documentation which was relevant to the management of the service including health and safety certification, training records, team meeting minutes and findings from management audits.
Updated
5 January 2018
This inspection took place on 14 and 16 November 2017 and was announced. The provider was given 48 hours’ notice of our inspection because the service provides care to people in their own homes and we needed to be sure someone would be in at the office.
Scope Lancashire Community Services is registered to provide personal care and support to people living in their own homes. Support is provided to people with learning disabilities, sensory impairments and people with physical disabilities. Some people received support through several visits per day and some people were receiving support 24 hours a day. 13 people were using the service at the time of our inspection visit. This was the first inspection of the service since registering with the Care Quality Commission (CQC) in November 2016.
A requirement of the provider's registration is that they have a registered manager. A registered manager is a person who has registered with the CQC 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. At the time of our inspection the registered manager was unavailable and had been unavailable since August 2017. They were due to return to work at the end of November 2017. The service had kept the CQC informed of this and in the absence of the registered manager we spoke with the area manager and the interim service manager to conduct the inspection. The interim service manager was running the service in the absence of the registered manager; we therefore refer to them as 'the manager' in the body of this report.
The manager and staff understood their responsibilities under the Mental Capacity Act (MCA) to ensure people were looked after in a way that did not inappropriately restrict their freedom or choices. However, some improvements were required around areas of re-assessment of people’s capacity. A recommendation has been made about this in the ‘Effective’ section of this report.
Most of the people who used the service could not express their views to us but their relatives told us that their family members felt safe with staff and staff treated them well. There were enough staff employed at the service to care for people safely and effectively. People were supported by staff who knew them well.
Checks had been completed before new staff started work to make sure they were safe to work with people in their own homes. The manager and staff understood how to protect people they supported from abuse and knew what procedures to follow to report any concerns.
Staff were supported by the manager through regular meetings. There was an out of hours' on call system in operation that ensured management support and advice was always available for staff. Staff felt their training and induction supported them to meet the needs of people they cared for.
People were protected from the risk of abuse. We noted that care plans and risk assessments were reviewed and updated when people’s health care needs changed or when new risks were identified.
Medicines were administered safely and people received their medicines as prescribed. People were supported to attend appointments with health care professionals when they needed to and received healthcare that supported them to maintain their wellbeing.
People were supported with their health needs and had access to a range of healthcare professionals where a need had been identified. Health professionals provided positive feedback about their relationships with the management and staff, which demonstrated people received effective healthcare. People were encouraged to eat a balanced diet that took account of their preferences and, where necessary, their nutritional needs were monitored.
The service had a person centred culture that was understood by staff. Where possible people were involved in planning their own care, often with the support of relatives, advocates and health professionals. This ensured care matched their individual needs, abilities and preferences from their personal perspective. Activities, hobbies and interests were based around people's wishes.
People and their relatives thought staff were kind and responsive to people's needs and people's privacy and dignity was respected. Staff offered people ways to maintain and develop their independence and increase their life skills.
Staff were positive about ways in which the service was managed and the support received from the management team. They described a positive working environment.
People's relatives were encouraged to share their views about how the service was run. People knew how to make a complaint and the one complaint that was received was fully investigated and responded to. The provider used the information from complaints and feedback to improve their service by acting on the information they received.
Quality assurance procedures were in place across the provider's group of services. Information was shared across each of the provider's services to ensure lessons learned drove forward improvements. Accidents and incidents were investigated and actions were taken to minimise the risks of a re-occurrence. There was a culture within the service to learn from feedback, audits, and incidents to continuously improve the service provided.