Obasan Services Limited

Obasan Services Limited is a domiciliary care agency. It provides personal care to people living in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. At the time of this inspection, eight people were receiving the regulated activity of personal care.

People's experience of using this service and what we found

People and relatives spoke positively about the service they received. We were given many examples that showed people received quality care and support from staff who ensured people were kept safe, were happy and felt well cared for.

Staff spoke knowledgably about all aspects regarding safeguarding people. Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice.

Risks were individually assessed, regularly reviewed, clear and covered all areas of people's health as well as any potential environmental risks. Risks assessments ensured staff were given current guidance and information to enable them to support people safely whilst allowing them to maintain their independence.

People were supported by sufficient numbers of trained, experienced staff to meet their needs. People received support from a consistent team of skilled staff that knew people well and delivered their care in ways people preferred.

Safe recruitment practices were followed. Appropriate checks were completed to ensure that only suitable staff were employed. There was a commitment to developing and supporting staff through regular training, supervisions, observations and appraisals. Staff spoke positively about the training they received which they told us was well delivered and of good quality.

Staff supported people to take medicines safely. Staff were trained in medicines management and knew how to ensure that people received their medicines on time and as they had been prescribed. Clear audit processes were in place to monitor the accuracy of administering and recording medicines.

There were robust procedures in place to ensure people were protected from infections that could affect both staff and people using the service. Staff had completed infection prevention and control training and understood the actions needed to minimise the risk of avoidable harm, including the prevention of avoidable infection. Staff had access to plentiful supplies of Personal Protective Equipment (PPE) and spot checks were in place to ensure staff were following current national guidance regarding the Covid-19 pandemic.

People, relatives, health and social care professionals and staff spoke highly of the registered manager. People felt the service was well led with a commitment to providing person-centred care.

Staff told us, and records showed, there was an open, honest, positive culture. Staff were provided with the training, skills and support to provide care to people which enabled them to live their lives as independently as possible whilst maintaining a good sense of wellbeing and happiness.

Governance systems had been improved. Audits had been revised and were being carried on a monthly basis. The registered manager said they had, “Much better oversight of the service now.”

People, relatives, health and social care professionals. and staff consistently spoke of the effective and clear communication they had with the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

We carried out an announced focused inspection of this service on 3 September 2020. A breach of legal requirements was found. The provider had conditions attached to their registration which required them to report to CQC once a month to advise of their progress with meeting the regulation of good governance. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained as requires improvement. This is based on the findings at this inspection.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Improvements have been made with the management oversight and auditing systems. Recruitment processes have been strengthened to ensure they are robust.

Why we inspected

This was a focussed inspection conducted in accordance with current CQC inspection guidance.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Obasan Services Limited on our website at www.cqc.org.uk.

Follow up. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Obasan Services Limited is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of inspection, the service was supporting 10 people.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Since our last inspection there has been some improvement made in addressing the shortfalls in management oversight of the safety and quality of the service. However, we have found that further improvements are needed to ensure they are effective. The service did not have some systems in place to ensure adequate monitoring and oversight.

Audits did not cover all aspects of the service which meant that risk assessments were out of date and not reviewed in line with the service policy. This meant people were at risk of receiving care that was not safe. Staff knowledge of people reduced this risk and we did not find anyone had been harmed by this failure.

Staff had received infection prevention and control training. However, people told us that staff do not always wear face masks as required by the service, the registered manager addressed this once raised. The registered manager told us they had kept up to date with the changing information during the Coronavirus pandemic and had sourced additional items such as hand gels, towels, bags for staff to use when supporting people.

People were positive about the care they received and told us staff were kind and reliable. People received their medicines safely and staff had the skills necessary to do their job. Staff felt supported and had confidence in the registered manager.

Learning and development was important to the registered manager and staff felt there was progression opportunities within the service. People were positive about the registered manager and were happy with the service they received.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (10 December 2019). We added conditions to the providers registration. The provider reported to us once a month to update us on their progress with meeting the regulations. At this inspection enough improvement had not been made and the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated inadequate once and requires improvement for three inspections.

Why we inspected

This was a planned inspection based on the previous rating.

We carried out an announced focused inspection of this service on 3 September 2020. A breach of legal requirements was found. The provider had conditions attached to their registration which required them to report to CQC once a month to advise of their progress with meeting the regulation of good governance.

We undertook this focused inspection to check they had made the improvements as stated in their monthly reports to us. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained as requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Obasan Services Limited on our website at www.cqc.org.uk.

Follow up

We will meet with the provider and request an action plan to understand what they will do to improve the standards of quality and safety. The provider will continue to report to us on a monthly basis. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Obasan Services Limited is registered to provide personal care to people living in their own homes. At the time of our inspection the service was providing personal care to eight people.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults and people living with dementia.

Obasan Services Limited office is situated in Poole. It provides support to people living in the Bournemouth and Poole areas.

People’s experience of using this service: Since our last inspection the management and oversight of the service had been enhanced. A new management structure was being implemented and a consultant had been appointed to support the improvements needed. Whilst substantial improvements had been made the systems to monitor the quality and safety of the service this work was ongoing. This meant that improvements were not yet support by robust systems and we were not reassured of sustainability.

Audits did not yet cover all areas of service delivery and information was not reliably used to drive changes or improvements. The risks associated with this were reduced by the commitment and diligence of staff committed to ensuring high quality care.

The registered provider had not ensured conditions of registration had been met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Consent and best interests decisions were not always formally recorded.

People received a person centred and responsive service from staff they liked and trusted. People and staff spoke about each other with respect and kindness and staff knew people well. People’s care reflected their needs and was flexible to fit their lives. The staff had received training to ensure they had the skills they needed to carry out their roles.

Staff were committed to supporting people to retain their independence and understood how to keep them safe. Most risks assessments were recorded and reflected people’s needs and wishes.

People were confident that they were listened to if they raised concerns or offered feedback. Complaints were recorded in line with the providers complaints policy.

More information is in the full report below.

Rating at last inspection and update: The last rating for this service was Inadequate (published May 2019) and there were breaches of regulation. Since this rating was awarded the service has moved premises. We have used the previous rating and enforcement action taken to inform our planning and decisions about the rating at this inspection. This service has been in Special Measures since May 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures. At this inspection enough improvement had not been made in relation to oversight and the provider was still in breach of one regulation.

Why we inspected:

This was a planned inspection based on the previous rating.

Enforcement

We have added conditions to the provider's registration. The conditions require the provider to report to CQC about the work they are undertaking to meet the requirements of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Follow up:

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Obasan Services Limited is registered to provide personal care to people living in their own homes. At the time of our inspection the service was providing personal care to eight people.

This service is a domiciliary care agency. It provides personal care to people living in their own homes in the community. It provides a service to older adults and people living with dementia.

Obasan Services Limited office is situated in Bournemouth town centre. It provides support to people living in the Bournemouth and Poole areas.

People’s experience of using this service:

¿ Systems to monitor the quality and safety of the service were inadequate.

¿ Audits did not cover all areas of service delivery and information was not used to drive changes or improvements.

¿ The registered provider did not have a good understanding about important legislation which frames care delivery.

¿ The registered provider had not made improvements identified at the last inspection and there were two continued breaches of the regulations.

¿ The registered provider did not consistently keep accurate and complete records about the service that people received.

¿ Risk assessments were not in place to ensure that staff had guidance about how to safely support people.

¿ Complaints were not formally recorded in line with the providers complaints policy.

Staff received training in some areas, but this did not cover all of people’s needs.

¿ People were positive about the service they received from Obasan Services Limited. Staff knew people well and people were comfortable with staff in their homes.

More information is in the full report below.

Rating at last inspection: Requires Improvement (published 8 October 2018)

The overall rating at this inspection has dropped to Inadequate.

Why we inspected:

This inspection was a scheduled inspection based on the previous rating.

Follow up:

At this inspection the service has been rated 'Inadequate'. Therefore, the service is now in 'Special Measures'. Services in special measures will be kept under review and, if we have not already taken immediate action to propose to cancel the provider's registration of the service, it will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not, enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This was the first inspection of this provider since they became registered with the Care Quality Commission in January 2018.

The manager and staff had a strong ethos of person centred care and worked hard to ensure that people had regular staff visiting them. This was appreciated by people and relatives who were mostly happy with the service they received and spoke highly of the staff and registered manager; identifying their caring natures and keenness to be responsive.

We found a number of areas of concern due to a lack of robust systems and oversight. There were breaches of regulation in relation to safe care and treatment, recruitment, the application of the Mental Capacity Act 2005 and the governance of the service.

People were at risk of harm because the oversight and administration of medicines was not robust, and risk assessments had not led to care plans containing current guidance for staff.

Staff understood how to identify and report abuse and were confident that concerns would be taken seriously by the registered manager.

Staff had not completed all the training the provider had determined to be essential to their roles, and whilst some of these staff had undertaken training with previous employers the registered manager did not have a system in place to record that their competence had been assessed.

Communication was considered and staff supported people to understand the choices available to them. People told us that staff enabled them to have choice and control of their lives. The systems in the service did not wholly support this as documentation to support the application of the Mental Capacity Act was not available.

Care planning and assessment did not always contain personalised information to ensure preferences were clear and to ensure characteristics protected by the Equalities act were respected. We have made a recommendation about this.

People and relatives mostly told us they could raise any concerns and these were addressed appropriately. We also received feedback from a relative who had not been happy with care and responsiveness.

Whilst the registered manager had contact with people, relatives and staff due to the size of the service. Quality monitoring processes had not been implemented.