Archived: Interserve Healthcare - Leeds

Updated 26 September 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 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 20, 24, 26, 25 and 27 July 2017and was announced. During this time we spent two days at the provider’s office and made telephone calls to staff, people who used the service and their relatives. The provider was given short notice of the inspection as we needed to be sure key members of the management team would be available at the office.

The inspection was carried out by one adult social care inspector and an expert-by-experience who had experience of domiciliary care services and carried out telephone calls to people who used the service and their relatives. 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 our inspection, we reviewed all the information we held about the service, including previous inspection reports and statutory notifications sent to us by the service. We contacted the local authority, other stakeholders and Healthwatch for their views. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

Before the inspection, the provider 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.

At the time of the inspection, there were 25 people using the service. During our inspection we spoke with two people who used the service, six relatives, five staff, the manager, the branch nurse and two client care managers.

We spent time looking at documents and records related to people’s care and the management of the service.

Updated 26 September 2017

This was an announced inspection carried out on the 20, 24, 26, 25 and 27 July 2017.

At our last inspection in March 2016 we identified three breaches of regulations. We found systems and processes were not operated effectively to report allegations of abuse in a timely way and systems were not in place to assess, monitor and improve the quality and safety of the service provided. We also found staff did not receive appropriate support through a robust programme of training.

At this inspection we found the provider had taken action and they were now meeting the requirements of these regulations. However, we recommended that quality assurance systems were reviewed to make sure they were strengthened. We saw there were processes in place to monitor and improve the service, however we found this had not always identified gaps on Medicines Administration Records (MARs). The manager had already begun to take action in response to this.

Overall, staff showed a good understanding of promoting choice and gaining consent from people. However, the registered manager and staff were not always acting in accordance with the requirements of the Mental Capacity Act 2005 and associated codes of practice.

The service is registered to provide personal care and/or treatment of disease, disorder or injury to people living in their own homes. Children and adults were supported. Three separate types of service were delivered; a service for people with complex health care needs, a home renal dialysis service and a service for people who required treatment through intravenous therapies.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like 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.

The home intravenous therapies part of the service was managed by a central team and the manager of Interserve Healthcare- Leeds did not have day to day management oversight of this service. During the inspection we were told that the provider had identified a manager for the intravenous service and a separate application for their registration was to be made.

People who used the service told us they felt safe when using the service. Staff understood their responsibilities under safeguarding and we found safe recruitment procedures were in place. Overall medicines were managed safely and people told us they received good support with their medicines. We saw risks were well managed, and staff understood how to ensure these risks were minimised.

There were enough staff employed to provide support and ensure that people’s needs were met. Staff received appropriate supervision, appraisal and training to enable them to carry out their role. Staff spoke highly of the support and training the received.

People who used the service told us staff were well trained, caring and kind. Staff showed a good knowledge of the people they supported, and understood how to maintain people’s privacy and dignity. Staff described the care they delivered in a person centred way. It was clear they had developed positive relationships with people.

People were supported to maintain good health and staff had a good awareness of how to support people with nutrition and hydration.

Care plans were reviewed regularly, and we saw people were involved in this process. Staff received timely updates to ensure they were aware of any changes in people’s needs.

There were systems in place for responding to people’s concerns and complaints. People told us they knew how to raise concerns if they had any.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the end of this report.