Archived: Purity Care

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found:

Is the service safe?

People were not always being cared for safely. People's needs were assessed but there was no system in place to regularly review the needs of those people being supported through the subcontracting arrangement.

There were not always safe recruitment practices in place. Staff files did not contain all information required under The Health and Social Care Act 2008. This meant the provider could not demonstrate that the staff employed were suitable or had the skills and experience to support people using the service.

Staff did not have sufficient knowledge in relation to their responsibilities to safeguard vulnerable adults. The provider had not taken appropriate action where concerns had been raised. This meant that people were not sufficiently protected from harm and abuse.

We have asked the provider to tell us how they plan to improve in these areas.

Is the service effective?

People being supported through a direct contract with Purity Care received care that achieved good outcomes. The provider carried out a detailed assessment that included people and their representatives and resulted in an individualised care plan. Staff understood people's needs.

People being supported through the sub-contracting arrangement with another domiciliary care provider did not always receive appropriate care. Where people's care needs required the support of two workers this was not co-ordinated effectively and resulted in care not being provided in line with the care plan. This meant that care was not always being provided effectively.

We have asked the provider to tell us how they plan to improve.

Is the service caring?

People were supported by a service that was caring. The registered manager had a caring approach to the people accessing the service. A relative told us that 'carers are really good, very nice.' The registered manager had regular contact with people using the service to check that everything was going well.

Staff told us the manager was very supportive, 'They [the manager] call me at the end of every shift to make sure I'm OK.'

Is the service responsive?

The service was not always responsive to people's needs. People being supported through the sub-contracting arrangement did not always receive a service that met their needs. When care staff reported changes to people's care needs, the registered manager passed the information to the contracted provider. However there was no follow up to ensure that action had been taken. This meant that people's care plans did not always reflect their needs.

Where there were late or missed visits these were not recorded or monitored. Staff told us they report to the registered manager if they were going to be late, however there was no evidence to indicate what happened as a result.

We have asked the provider to tell us how they are going to improve in these areas.

Is the service well-led?

The service was not always well-led. There were no systems in place to monitor the quality of the service, either for the direct contracting or sub-contracting arrangements. The provider had a complaints and comments policy but there was no evidence of this being implemented for people being supported through the sub-contracting domiciliary care provider. This meant that feedback from people could not be used to improve the service.

There was no system in place to record, investigate and learn from accidents and incidents. The registered manager told us that there had been incidents but there was no formal recording of these. This meant the provider could not monitor trends or implement learning from adverse events.

The registered manager was unclear about her responsibilities as a registered manager in relation to the subcontracting arrangement. There was no evidence of a clear governance arrangement for Purity Care when monitoring and responding to the subcontracted element of the service.

We have asked the provider to tell us how they are going to improve in this area.