Background to this inspection
Updated
19 October 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.
The inspection took place on 10, 11 and 16 August 2017 and was announced. We announced the inspection 72 hours in advance as the service provides care in people’s home and we needed to ensure someone could meet us at the office. We also needed to give time for the registered manager to contact relatives and staff so they could consent to our speaking with them.
The inspection was completed by one 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.
Prior to the inspection we reviewed our records including the previous inspection report and provider’s action plan. The registered manager had submitted a Provider Information Return (PIR). The PIR 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 used the PIR as part of our planning for the inspection.
On the first day of the inspection, we visited the office and reviewed three people’s care records. We read three staff personnel, training and supervision records. We looked at how the registered manager was ensuring staff training was up to date. We also reviewed how the registered manager and provider measured the quality of the service.
On the second day, we spoke with four relatives and four staff by telephone with the third day reviewing records of staffing further.
Updated
19 October 2017
The inspection took place on 10, 11 and 16 August 2017 and was announced. We announced the inspection 72 hours in advance as the service provides care in people’s home and we needed to ensure someone could meet us at the office. We also needed to give time for the registered manager to contact relatives and staff so they could consent to our speaking with them.
We last inspected the service on 26 July and 2 August 2016. We found breaches of Regulations in respect of how the service was ensuring they were staffed safely and meeting people’s needs in a personalised manner. The service was judged to be Requires Improvement overall. They were also Requires Improvement in respect of the whether the service was safe, effective, responsive and well-led. Whether the service was caring was judged to be Good. The registered manager sent us an action plan on how and when they were going to put this right. They told us this would be put right by December 2016. We checked on this inspection and found the issues raised in 2016 had been addressed.
Scope Inclusion South West (referred to as Scope South West) provides care to people in their own homes. Care can be provided to all ages from children to older people. At the time of the inspection eight people were receiving personal care and were aged between four and 64 years. People’s needs could include physical disabilities, sensory impairment, learning disabilities and autistic spectrum disorder.
A registered manager was employed to manage the service locally. 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.
Systems were not operated effectively to ensure there were enough staff to meet the requirements of people’s care plans at all times. The provider had recruited more staff since the last inspection and the percentage of missed shifts had fallen. However, the contingency plan was not always working to make sure staffing needs were met where there was advance or short term notice. The provider’s quality auditing had not ensured staffing was identified as an on-going need. Having identified the service was not meeting 100 per cent of staffing, this had been challenged further.
Staff were recruited safely and trained to meet people’s individual needs. Wherever possible people were only cared for by staff known to them and trained to meet their needs. Relatives told us they felt staff were caring, considerate and able to meet their loved ones needs in a caring way.
People’s care was planned in a personalised way and people’s relative and relevant professionals were involved in planning and meeting their needs. People had the necessary risk assessment in place to keep them safe. People’s health needs were identified and acted on. Staff understood how important consent was and the requirements to ensure they were acting in people’s best interests (adults) or parental consent (children) where this was required. People were supported to stay active in their community and access local facilities.
Relatives felt their loved one was safe with staff. Staff were trained in safeguarding adults and children and understood how to raise a concern. Staff felt the registered manager and other senior staff would act to keep people safe. The provider had a whistle blowing policy which staff knew about and would use if their concerns were not listened to.
People’s needs were met where staff were responsible for people’s medicine and ensuring people had enough to eat and drink. Clear records were kept and issues followed up on.
Staff liked working for the service and told us the registered manager and other senior staff were approachable and supportive. Relatives were involved in planning the care of their loved one and asked their view of the running of the service. Complaints were investigated and ensured they were fully concluded to the complainant’s satisfaction.