This inspection took place on the 10 & 11 March 2016, the first day was unannounced. The manager was present throughout the inspection and was cooperative throughout the inspection process. The manager was part way through the process to become the registered manager for the service. 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.
We last inspected the service in June 2014. We identified a breach of regulation for medicines management. An action plan was received and a pharmacy inspector inspected the service in October 2014 and judged the service to be compliant for medicines management.
HICA Homecare Chorley is a domiciliary care agency registered to provide personal care for people in their own homes. The agency provides care and support services as the preferred provider for two extra care schemes, the 'Buckshaw Retirement Village' in Chorley and 'Brookside' in Ormskirk. The service was also looking to provide domiciliary care within the wider community going forward.
At the time of our inspection the service was delivering approximately 800 hours of care per week across both extra care schemes as well as providing an emergency response service to all the people living within both complexes, whether they had a commissioned service or not.
The service had procedures in place for dealing with allegations of abuse.
Staff were able to describe to us what constituted abuse and the action they would take to escalate concerns. Staff members spoken with said they would not hesitate to report any concerns they had about care practices.
We found that a number of people who were assisted with taking their medicines, some on an ad hoc basis, had no risk assessments in place within their care plan. We also found no risk assessments for people who self-administered their medicines within the care plans we reviewed.
We asked people if there were enough staff to meet their needs. We mainly received positive comments however a couple of people raised concerns regarding how much time staff had with them.
We asked staff about the continuity of care for people, i.e. if they visited the same people regularly. They told us that this did happen for the majority of the time unless there was unplanned absence such as short term sickness.
The service had effective recruitment policies and procedures in place which we saw during our inspection.
People we spoke with told us their needs were met in the way they wanted them to be. They spoke highly of the staff that supported them and told us that they believed the staff to be competent, caring and approachable.
We saw that staff attended regular training via the staff training matrix we were given and also found evidence within staff files.
We spoke with staff regarding their understanding of the MCA, the responses we received were good in terms of their understanding of the legislation and staff were very knowledgeable when discussing the issue of consent.
We asked people if they always got enough to eat and drink throughout the day and night. Many people were able to get a drink themselves, but people with less independence told us that they had drinks left for them within reach and we saw evidence of this during our inspection.
We spoke with staff on issues such as confidentiality, privacy, dignity and how they ensured that people retained as much independence as possible whilst being supported. Staff were knowledgeable in all areas and were able to talk through practical examples with us.
Good information was provided for people who were interested in moving in to the service. The service users’ guide and statement of purpose outlined the services and facilities available, as well as the aims and objectives of HICA Homecare.
We found people’s care and support plans to be lacking in detail, with some of the information being task orientated and not personalised to the individual.
People we spoke with told us they knew how to raise issues or make complaints. They also told us they felt confident that any issues raised would be listened to and addressed.
People we spoke with talked positively about the service they received. People spoke positively about the management of the service and the communication within the service.
A range of Quality Audit systems were in place at the service which we saw evidence of.
We found two breached of the Health and Social Care Act (2008) (Regulated Activities) Regulations 2014. These related to; Safe care and treatment and Person centred care.
You can see what action we told the provider to take at the back of the full version of this report.