Archived: Caring For You Adults and Childrens Services

Updated 22 November 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 10 October 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 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 supporting this inspection had experience of caring for a relative who was living with a disability.

Before the inspection we reviewed previous inspection reports, safeguarding records and other information received about the service. We checked if notifications had been sent to us by the service. A notification is information about important events which the provider is required to tell us about by law. We viewed the 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.

During the inspection we spoke with five relatives, five support workers, the registered manager and nominated individual, a representative of the provider. We were unable to speak to people who were receiving this service because three people were under the age of 16 and one person who was over the age of 16 was unavailable.

We reviewed a range of records about people’s care and how the service was managed. We looked at plans of care for three people which included specific records relating to people’s capacity, health, choices, medicines and risk assessments. We looked at daily reports of care, incident and safeguarding logs, compliments, complaints, service quality feedback forms, audits and minutes of meetings. We looked at the training plan for four staff members and recruitment, supervision, appraisal and training records for three staff members.

We asked the provider to send us information after the visit. We requested copies of their policies and procedures and training plan. This information was received.

Updated 22 November 2016

We carried out an announced comprehensive inspection of this service on 7 July 2014. One breach of the legal requirements of the 2010 Regulations which corresponded to the 2014 Regulations was found. People were not always protected from the risk of unsafe or inappropriate care due to the lack of accurate records being maintained. Care plans did not always include full details to ensure staff knew how to provide safe and effective care and the registered manager was not fully aware of the type of support some people needed and as a result care plans were not adequately reviewed. We requested the provider send us an action plan outlining what they would do to meet the regulations. The action plan was received on 9 June 2015 stating the actions would be met by December 2015.

We undertook this announced comprehensive inspection on 10 October 2016 to check whether the service had followed their plan and to confirm that they now met legal requirements.

At the inspection on 10 October 2016 we found the provider had taken steps to address some of these concerns and had improved their knowledge of the support people needed. Care plans and risk assessments had been reviewed and contained detailed information to ensure staff knew how to provide safe and effective care. However quality and safety audits remained ineffective.

Caring for You Adults and Childrens Services provides support and personal care services to young adults, adults and children living with physical and or learning disabilities or autism in their own home. At the time of our inspection there were 14 people receiving this service, however only four people were in receipt of personal care. Three people were under the age of 18 and one person was above the age of 18. There were 13 support workers employed by the service and six of these support workers provided personal care to people. One of the support workers was also a senior support worker who would support the registered manager to complete care plans and risk assessments.

There was a registered manager in place. 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.

Quality and safety audits were not completed effectively. Information in completed surveys were not collated, analysed or used to improve the quality of the service. Incidents and accidents were not always identified, investigated or mitigated to prevent reoccurrence.

Staff had received training on the Mental Capacity Act 2005 but demonstrated a lack of understanding of how the Act could relate to their work and impact people who were over the age of 16 who may lose their capacity. We made a recommendation to the registered manager for them to review the Mental Capacity Act 2005 and its relevant codes of practice.

The registered manager had heard of the Care Certificate but staff had not, however staff did have other relevant professional qualifications in health and social care which gave them the knowledge to complete their role effectively. The care certificate had not been used within the service as new staff had not been recruited since the last inspection in July 2014. There was a comprehensive induction process.

The ratings from the inspection completed on 7 July 2014 had been displayed on the provider’s website. However the inspection report for the inspection completed on 11 February 2014 had been displayed in the office, not the July 2014 report.

Risk assessments were in place and contained sufficient detail to ensure staff had the knowledge to provide safe care. Safeguarding policies and processes were in place and staff had received training and had an improved knowledge of these policies, processes and how to report concerns.

There were enough staff because the service could be flexible to meet people’s needs with the agreement of the relatives. There was good continuity of staff and they were on time and provided the full duration of support. Staff received training on medicines and were able to support people with their “as required” medicines. People’s daily medicines were given by their relatives.

Staff were trained in a number of relevant subjects, could request and were given training on specialist courses such as gastrostomy and epilepsy and these were refreshed regularly. Staff received a regular supervision and appraisal and felt well supported.

People who required support with eating and drinking were supported to do so in line with their care plan and needs. Staff supported relatives when people required access to healthcare professionals and other professionals.

Staff were kind, caring and respected people’s privacy and dignity whilst promoting their independence. Where appropriate people were involved in the development of their care and gave informed consent to their daily care. People’s ethnicity and cultural requirements were met.

Relatives felt listened to and could raise any concerns about their relative’s care.

People’s needs were regularly assessed and reviewed. People’s care plans were detailed, up to date and personalised. Activities completed were age appropriate and meaningful to people and their relatives. A complaints process was in place; however complaints had not been received since the last inspection.

Positive comments were received about the registered manager by staff and relatives. The registered manager had an open door policy and communicated well with staff and relatives. Relatives and staff had confidence the registered manager would listen to their concerns and the concerns would be received openly and dealt with appropriately.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We have also made a recommendation. You can see what action we told the provider to take at the back of the full version of this report.