About the service PRN Homecare- Bognor Regis is a domiciliary care agency providing care and support to people living in their own homes who have a range of needs. CQC only inspects where people receive personal care. Not everyone who used the service received personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection 64 people were receiving personal care.
People’s experience of using this service and what we found
People were supported by familiar and consistent staff who knew their care needs and understood how to meet these safely. Risks to people had been assessed, however further information was needed so that staff could safely meet people’s identified health needs and associated risks. There were enough staff employed to meet people’s needs and there were clear recruitment procedures in place. However, full employment histories were not always obtained from applicants to check their suitability to work with the people they supported.
People and their relatives told us they felt staff who supported provided safe care. Staff told us they would report any safeguarding concerns. People told us they were supported by reliable staff who were on time. People were supported, when required, to receive their medicines as prescribed.
Staff received training that equipped them in their role. However, we found that they had not received specific training in the mental capacity act and this had impacted on compliance with this legislation.
People told us staff obtained their consent before supporting them with care and support. However, people were not always supported to have maximum choice and control of their lives. The provider did not have records to evidence that people were supported in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
Where required, people were supported to eat and drink sufficient amounts to remain healthy and were supported to access healthcare professionals when needed.
People and their relatives told us they were happy with the care they received and thought the staff were kind and caring. Staff supported people to maintain their independence where possible, and to remain involved in decisions about their care. People told us that staff respected their dignity and privacy. Staff supported people to develop and maintain important relationships.
People had care plans which were reviewed regularly. They contained details about people’s individual needs. However, further improvement was needed to develop more person-centred care plans, that captured people’s protected characteristics and life histories.
People were supported by a consistent team of staff who knew them well. This meant that staff and the provider understood people's individual needs and tailored the service where possible, to support people. People knew who to make complaints to and were confident they would be listened to.
People and staff told us that the provider and manager were approachable and responsive. People were able to feedback their views of the service.
Quality assurance processes and systems in the service were not always robust. Some notifications which are required to be sent to CQC, had not been submitted. These were submitted following the inspection and the provider has assured us any further relevant incidents will be notified, as required.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 8 May 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
Enforcement
At this inspection, we identified breaches of regulations in relation to the Mental Capacity Act, the protection of people's rights and freedoms, notifications of incidents to CQC and quality assurance systems. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for 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.