This inspection took place on 26 and 28 April 2016 and was announced. Carers Sitting Service is registered to provide personal care to people living in their own homes. At the time of our inspection, 12 people were receiving personal care. Carers Sitting Service also provides a short respite service for family and friends who care for people in their own homes. For example, by cleaning, support with shopping, and sitting with a person so that family carers can attend appointments. These activities are not regulated, and are not inspected by the Care Quality Commission.The service had a registered manager in post at the time of our inspection. 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.
People’s needs were assessed, but risks associated with personal care were not adequately identified. Appropriate protective measures were not put in place to minimise the risk of avoidable harm. Care plans were not reviewed and updated regularly to reflect people’s changing needs.
The provider could not assure themselves that medicines were being managed in accordance with current regulations and guidance. Care plans were unclear about the level of support people needed with medicines, and there was no system in place to ensure that people received medicines as prescribed.
The provider could not demonstrate that all staff received training to ensure they had up to date skills and knowledge to provide effective care. Staff felt supported but they had not received regular one to one supervision. Most staff had not had one-to-one supervision with their manager in the last year, and over half the staff had not had an annual appraisal in the last year. The registered manager and deputy manager had received training in the Mental Capacity Act 2005 (MCA), but care staff had not undertaken any training in relation to capacity and consent.
The provider did not have adequate systems in place to monitor and review the quality of care people received. The local authority had identified concerns about risk assessments, quality of information in care plans, training and staff supervision and medication auditing. The provider was aware of these concerns, but had not undertaken the work required to resolve the issues.
Safe recruitment procedures were followed and appropriate pre-employment checks were made. Checks were undertaken to ensure new staff were safe to work in the care sector.
People were able to make their own choices about their personal care, and were involved in planning and reviewing their care. There were enough staff to meet people’s personal care needs at the time when they needed support.
People were happy and comfortable with staff and said they felt safe. Staff were trained and understood how to recognise abuse, and were confident to raise concerns.
There was a complaints process in place, and people were encouraged to express their views about the service. People and relatives felt confident to make suggestions for improvement of care or raise concerns.
Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.