Archived: Omnia Support limited

Omnia Support is a community based care provider that provides personal care and support to people in their own homes. At the time of our inspection there were 122 people receiving personal care.

People’s experience of using this service and what we found

People told us they felt safe and staff knew how to keep them safe from harm. The provider had a recruitment process to ensure they had employed suitable staff to support people safely. People received their medicines as prescribed. Staff followed infection control guidance and had access to personal protective equipment. Accidents and incidents were recorded and appropriate action taken.

Staff had the skills and knowledge to meet people's needs. People were supported to eat a healthy diet and care staff knew people’s specific dietary requirements. People were supported by regular staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by staff who were kind and caring and knew them well. People's privacy, dignity and independence were respected by staff.

People's support needs were assessed regularly and planned to ensure they received the support they needed. The provider had a complaints process which people were aware of to share any concerns.

The service was well managed. Feedback questionnaires were used to gather information about people’s views. Spot checks and audits were carried out to ensure the quality of the service was maintained.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

Rated good overall (report published 01/03/2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service was last inspected in July 2016 and rated as inadequate overall. This was because we had identified concerns in relation to risk management, recruitment practices and systems for investigating concerns and monitoring the quality of the service. We also found during our inspection in July 2016 issues related to people not always being treated with respect and dignity and we found that people did not always receive safe care and treatment in line with their needs.

At this inspection, we found that the registered provider had addressed and resolved the majority of concerns that we had identified at our last inspection. The registered provider was able to demonstrate how they had met their action plan and the breaches of regulation identified during our last inspection. We found that there were areas of further improvement required in respect of record keeping and auditing processes, to reflect and support the improvements of the service and the quality of care that people received.

People told us they felt safe using the service. Staff we spoke with were aware of people’s needs and how to support people with their associated risks, although records and assessments were not always in place to reflect this practice. Staff were aware of how to protect people through safeguarding processes and in the event of an emergency.

People told us that they received their calls on time and were notified by staff otherwise. Improvements had been made to recruitment processes to ensure that people were supported by staff who were suitable.

Some people received support with managing their medicines, people and relatives we spoke with told us they were satisfied with this support. Medicines audits had not always identified where medicines records and processes were not always clear and consistent.

People were supported by staff who were confident and equipped in their roles. Staff received spot checks, supervision and training for their roles. New staff were supported to complete an induction and shadowed other staff to aid their development.

People were supported by staff who were clear of their responsibilities in relation to the MCA, although records and processes did not always reflect this practice and how staff were to support people who did not have the mental capacity to make specific decisions.

Staff supported some people with meal preparation, the manager had identified that record keeping required improvement in this area. People were supported to seek healthcare services by staff who were proactive in raising concerns as necessary about people’s health needs.

People and relatives told us that staff were kind and caring. People were treated respect, and their dignity and independence promoted by staff who were familiar with their needs.

People received care that reflected their expressed needs and preferences. People and relatives were comfortable with raising concerns, complaints were resolved and addressed promptly.

The registered provider had implemented systems through which they could maintain oversight of the service, although audits and records were not always robust. The registered provider told us they had further plans for progressing and driving up the quality of the service.

Staff told us they felt supported in their roles and we found that steps had been taken to improve communication at the service. The registered provider had strengthened their leadership structure to support the running of the service.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

The service was last inspected and rated in July 2015 when it was rated as overall requiring improvement and specifically we found at the time that there were concerns in relation to risk management and quality assurance processes.

We could not be assured that people were always kept safe by the service. Recruitment processes were not always robust and some staff had commenced employment ahead of the completion of pre-employment checks. The manager had expanded on the information required by the registered provider to assist in determining the suitability of some applicants. Some people had experienced missed or late calls and the registered provider had not taken action to address this on-going issue. Guidance and processes were not always in place to help staff understand people’s needs and manage their risks effectively. Staff had not always responded appropriately to emergencies. Staff supported some people and relatives to take their medicines, however records were not robust. Action had not been taken to ensure that people received their medicines safely and as prescribed.

Most staff could tell us about some types of abuse that people were at risk of and how they would appropriately report these. We saw that the manager had raised some safeguarding concerns to help keep people safe.

People were supported by staff that had received up-to-date training for their roles and some people we spoke told us that staff met their needs. Staff told us that they felt supported in their roles and new staff were supported to complete the Care Certificate. The manager held staff meetings and told us they had intentions to improve spot checks and ensure that staff received supervision and appraisals.

Staff were not aware of the principles of the MCA, however some staff told us ways they had supported people to make decisions. Staff supported people with preparing meals and accessing healthcare support as required.

People and relatives we spoke with told us that staff were mostly caring and provided positive feedback about their consistent carers, however staff did not consistently treat people with respect. The registered provider had not established a process to ensure that people were supported by consistent staff or to notify people when this was not possible. This had caused people and relatives on-going concern.

People and relatives had expressed dissatisfaction with the service and we found that their complaints had not always been addressed appropriately. The registered provider had failed to establish processes around this.

The registered provider did not maintain sufficient oversight of the service to ensure that people received a service that always met their needs, kept them safe and complied with the regulations. The registered provider had failed to fulfil all requirements of their registration as there had not been a registered manager working at the service for over twelve months.

The manager had recently joined the service and had identified and addressed some concerns within this time. Staff we spoke with told us that they felt supported in their roles and trusted that the manager would improve the service.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Risks to people were not effectively assessed and managed, which included failures to effectively deploy staff and to follow safe and lawful recruitment practices. The registered provider did not have sufficient oversight of the service to manage such risks to people or specific risks relating to their care needs, or to monitor the quality of the service and investigate concerns. People did not always receive safe care and treatment that met their needs and they were not always treated with respect and dignity.