Archived: Interserve Healthcare - Leicester

Updated 15 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 6 September 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 people would be available to talk with us.

The inspection team consisted of two inspectors 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 the inspection we reviewed all the information we held about the service. Prior to the inspection, the provider had completed a 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. We also reviewed notifications that we had received from the service about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send us by law. We contacted local authority and health services commissioners who funded some of the people using the service to gain their views about the service. Commissioners told us they had no concerns about the service and people's care reviews were up to date.

During our inspection we spoke with two people and four relatives of people who used the service, four care staff, one clinical lead and the registered manager. We also observed staff working in the office dealing with issues.

We reviewed a range of records about people's care and how the service was managed. These included the care records for three people, three staff recruitment and training records, quality assurance audits, incidents reports, complaints and records relating to the management of the service. We also spoke with one health and social care professional after the inspection to gain their views of the service.

Updated 15 November 2016

This inspection took place on 6 September 2016 and was announced. We gave the provider 48 hours' notice of our visit because the location provides domiciliary care and we needed to make sure there would be someone in the office at the time of our visit.

Interserve Healthcare - Leicester is registered with the Care Quality Commission to provide personal care to people who wish to remain independent in their own homes. The agency provides services throughout Leicester and surrounding areas and provides for people with complex healthcare and social care needs. At the time of our inspection there were 10 people using the service who were supported by 73 staff.

There was a registered manager in post. 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.

This was our first inspection of the service since they registered with us.

There were good systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe.

The provider had arrangements in place for the safe administration of medicines. Staff supported people to manage their medicines safely.

People, their relatives and staff felt there had been instances where there were not enough staff through rota errors or unavailability of staff to cover at short-notice. The registered manager had recently recruited more staff to ensure there were always enough staff to meet people's needs as detailed in their care plans. The registered manager followed the provider's safe recruitment practices. This helped to ensure people were cared for by staff who were suitable for the role.

Staff usually arrived on time and stayed for the time allocated. People were cared for by suitably trained staff which helped to keep them safe and meet their needs. Staff understood people's needs and complex health conditions.

Staff understood the relevant requirements of the Mental Capacity Act (2005) and how it applied to people in their care. People's individuality was at the centre of how their care was delivered. They were fully involved in making decisions about their care.

Staff worked with both internal and external healthcare professionals to obtain specialist advice and support about people's care. Staff supported people to manage their complex health conditions, including nutrition and hydration and general health and well-being.

People's care plans were person centred, detailed and written in a way that described their individual care and support needs in detail. These were reviewed and changes made where required. This meant that everyone was clear about how people were to be supported and their personal objectives met. People using the service and those who were important to them were actively involved in deciding how they wanted their care and support to be delivered.

The provider had a complaints policy which provided people and their relatives with clear information about how to raise any concerns and how they would be managed. People and their relatives confirmed they felt comfortable to raise concerns and complaints to the provider.

People, their relatives and staff had low confidence in the communication and consistency of the management team on a day-to-day basis. People told us they had not been empowered to share their views of the service although they did have opportunity to feedback on their care individually. People and relatives had little contact or opportunity to discuss concerns with the registered manager. We found the registered manager and provider had systems in place to monitor the quality of care. These included audits of key aspects of the service and spot checks of staff working practices. However, we found that audits and observations of working practices were not consistently carried out to ensure staff were providing quality care. Staff we spoke with did not feel they received the consistent supervision and support they needed to develop within their role. Further improvements were needed to ensure outcomes of audits were actioned in a timely way.