Archived: Firstpoint Homecare - Leicester

Updated 3 February 2017

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 had made improvements following our last inspection on 24 February 2016 when we rated the service as requiring improvement. Our inspection was brought forward after we received a concern from a relative of a person who used the service. At this inspection we checked 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 21November 2016 and was announced. The provider was given 48 hours’ notice because the service is a home care agency and we needed to be sure that the manager would be in the office. We returned announced to the service on 25 November 2016 to complete our inspection.

The inspection team consisted of an 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.

Before we visited the office on 21 November 2016 we made telephone calls to people using the service or their relatives. We spoke with five people who used the service and relatives of 10 other people.

On the day of our site visit we looked at 12 people’s care plans and associated records. We looked at information about support staff received through training and appraisal. We looked at a staff recruitment file to see how the provider operated their recruitment procedures to ensure they only recruited staff that were suited to work for the service. We looked at records associated with the provider’s monitoring of the quality of the service. We spoke with a director of Firstpoint Home Care Ltd who took over the running of the service in September 2016, a clinical lead who supported the this service and others in the midlands, a coordinator who organised and monitored home care visits and four care workers.

We contacted the local authority that funded some of the care of people using the service and Healthwatch Leicester, who are the local consumer champion for people using adult social care services, to see if they had feedback about the service.

Updated 3 February 2017

The inspection visit took place on 21 November 2016 and was announced. We gave the provider 48 hours’ notice because the service is a small home care agency and the manager is often out of the office supporting staff or providing care. We needed to be sure they would be in. We returned announced to the service on 25 November 2016 to complete our inspection.

The service provides personal care and support to people who live in their own home in parts of Leicestershire. At the time of our inspection 31 people were using the service. The service was run from an office located in a small business park. When we arrived for our inspection we found that the service had moved from Suite 1 & 2 to a new location, The Dairy, within the business park.

The service has not had a registered manager since June 2015. 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. A manager who intended to apply to be a registered manager left the service in September 2016. The provider has arranged for a director to run the service. At the time of our inspection no person had applied to be registered manager.

People who used the service told us they felt safe. They were supported and cared for by staff that had been recruited under recruitment procedures that aimed to employ only staff that were suited to work at the service were employed. Disciplinary procedures were used after the provider had identified unsafe and dishonest actions by staff. Staff we spoke with understood their responsibilities for protecting people from abuse and avoidable harm. However, some people’s care and support was neglected because care workers were not punctual or because some home care visits were missed.

People’s care plans included risk assessments of activities associated with their personal care and support routines. The risk assessments provided information for care workers to support people safely without restricting their independence.

Enough suitably skilled and knowledgeable staff were deployed to meet the needs of the people using the service. However, care workers were often too early or late for home care visits. Relief care workers who were less knowledgeable about people’s needs had to be allocated home care visits at short notice when regular care workers were absent.

People were supported to take their medicines by staff that were trained in medicines management. However, people were not always supported with their medicines at the right times.

Care workers were supported through supervision and training. The provider used staff meetings to remind staff about safe practices and the standards that were expected of them. However, people told us that care workers who visited them less regularly did not appear to know how to support them. Not all care workers acted in accordance with the provider’s guidance about treating people with respect.

The director understood their responsibilities under the Mental Capacity Act (MCA) 2015. Staff we spoke with had little awareness of the MCA but they understood they could provide care and support only if a person consented to it.

People were supported with their meals. Care workers supported people to make meals or by heating ready prepared meals.

People were involved in decisions about their care and support but their preferences, for example about times of home care visits, were not always respected. They told us they were treated with dignity and respect by their regular care workers but not by care workers who visited them occasionally.

People contributed to the assessment of their needs and to reviews of their care plans. Their care plans were centred on their individual needs. However, not all care workers provided care and support that was in line with people’s care plans. This meant people did not consistently experience care and support that met their needs. People knew how to raise concerns but they were not always confident their concerns were acted upon by the provider.

The provider had arrangements for monitoring the quality of the service. These arrangements included asking for people’s feedback about the service and a range of checks and audits. Although the provider had a process for monitoring and reporting about punctuality of home care visits this was not consistently used. This meant shortfalls in the delivery of care were not promptly identified and acted upon. A director had been sent to run the service and make improvements. There was no action plan of what those improvements were or how they would be achieved.

We found one breach of regulation. You can see what action we told the provider to take at the back of the full version of the report.