Background to this inspection
Updated
28 April 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 4 inspectors and 2 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
Inspection activity started on 21 February 2023 and ended on 23 March 2023. We visited the location’s office on 22 February 2023, 16 March 2023 and 22 March 2023.
What we did before the inspection
We reviewed information about the service from on-going monitoring such as information we had received. We sought feedback from the local authority, and other professionals who work with the service.
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We used all this information to plan our inspection.
During the inspection
During the inspection we spoke with 10 people and 6 relatives. We also spoke with the registered manager, the area manager, a care coordinator, a quality assurance lead and 10 staff. We looked at the care records for 7 people. We checked the care people received matched the information in their records. We looked at records relating to the management of the service, including audits carried out within service.
Updated
28 April 2023
About the service
Cera - Staffordshire and Stoke is a domiciliary care agency providing personal care to people living in their own homes. The service provides support to people with dementia, learning disabilities or have autistic spectrum disorder, mental health issues, physical disabilities, sensory impairment, older people and younger adults. At the time of our inspection there were 185 people using the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support:
People were supported to have maximum choice and control of their lives. Staff knew people well and understood how they were to be supported in the least restrictive way possible and in their best interests. However, the policies and systems in the service did not always support this practice.
People’s care plans and risk assessments did not always identify how to support them with their individual needs. However, people were supported by staff who knew them well to be able to support them with their needs and to have choice and control in their lives.
Right Care:
Some improvements were needed to people’s care plans and although plans were person centred, these were not always updated in a timely way and not all health risks were assessed and planned for. People and relatives told us they felt safe with their carers. Staff had received mandatory training to be effective in their roles in supporting people.
Right Culture:
People and staff told us they had experienced communication issues with the office staff and issues reported to them were not always acted on. The registered manager had already identified this and was putting measures in place to address it. Some people and relatives told us care calls were sometimes late, and this had caused upset. The registered manager was responsive to our feedback about a potential safeguarding issue and took some immediate action to ensure people were made safe.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (17 March 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We received concerns in relation to safeguarding and call times. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cera – Staffordshire and Stoke on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safeguarding, staffing and governance and oversight at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.