Archived: Out of Hours Team

Updated 28 October 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.

This inspection took place on 13, 14, 15 and 20 September 2016 and was announced. The provider was given short notice because the location provides a domiciliary care service and we needed to be sure that the manager was available.

The inspection team consisted of two adult social care inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert used had experience of domiciliary care services.

Before the inspection we reviewed information we had received about the service from the local authority commissioning and safeguarding teams as well as notifications received. 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. They did not return a PIR and we took this into account when we made the judgements in this report

During the inspection, we reviewed five people's care files, some in detail and other to check specific information, four staff files, medicine records, staff training information as well as records relating to the management of the service.

On 20 September 2016 we visited and spoke with two people in their own homes and one relative as well as a care and support worker. The expert by experience spoke with four members of staff and seven people who used the service on the telephone on 13, 14 and 15 September 2016.

Updated 28 October 2016

Our inspection of the Out of Hours Team took place on 13, 14, 15 and 20 September 2016 and was announced. We gave the service short notice to ensure the manager would be present. The service was last inspected in December 2013 when it had complied with all legal requirements inspected at that time.

The Out of Hours team is registered with the Care Quality Commission as a domiciliary care agency providing personal care and support to people in their own homes in the upper valley, central and lower valley areas of Calderdale. The team’s office base is situated near Halifax town centre. At the time of our inspection the Out of Hours team was supporting 33 people to retain their independence and continue living in their own home.

The service should have a registered manager in position. 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. The registered manager had recently left the service and a new manager had been employed who had applied to be registered with the Care Quality Commission.

Appropriate systems were in place to protect people from risk of harm although some risk assessments required updating. People who used the service told us they felt safe with the care they received.

Policies and procedures were in place regarding the Mental Capacity Act 2005 (MCA) which helped to make sure people’s rights were protected.

People were provided with care and support by staff who had the appropriate knowledge and training to safely and effectively meet their needs. We saw the skill mix and staffing arrangements were sufficient for the current needs of the service.

People told us they generally saw the same staff members and care and support was provided without staff rushing.

Safe and robust recruitment processes were in place. Checks to show staff were safe to work with vulnerable adults were undertaken prior to staff working at the service.

Staff received induction and training relevant to their role and were offered opportunities for on-going development. Regular supervisions, appraisals and spot checks had not taken place. The new manager was introducing a system to ensure these took place in future.

Staff turnover was low and people were generally supported by regular staff. Staff were able to tell us about people who used the service, their care and support needs and how they treated people with dignity and respect. People we spoke with told us staff were considerate, caring and respected their dignity and privacy. People said they received a good standard of care and support.

We saw care and support was delivered in line with people's care plans and people were consulted about the care and support required. The manager had recently reviewed care records and saw these needed to be more detailed with more information about people's likes, dislikes and preferences.

Policies and procedures relating to the safe administration of medicines were in place. However, the recording of medicines was not robust.

People were supported to access a range of healthcare professionals. We saw evidence people's healthcare needs were met.

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Staff were not currently supporting anyone with specific nutritional needs due to the nature of the service but ensured people were offered drinks to support hydration needs.

A complaints procedure was in place which enabled people to raise any concerns or complaints about the care or support they received. However, some people told us they felt concerns they had raised were not dealt with. The manager was implementing a more robust procedure to ensure all complaints were documented, analysed and appropriate actions taken.

People using the service, relatives and staff we spoke with were positive about the management team. Staff said they felt supported and the management team were approachable. Staff turnover was low.

The manager recognised there was a lack of quality assurance monitoring systems in place to monitor and identify any shortfalls in service provision and was taking steps to improve this. The service had received a lack of provider governance, support and oversight.

The new management team had planned monthly staff meetings throughout the year although we saw and staff told us these had not been held regularly before they commenced in post.

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