Archived: Care Preference Limited

Care Preference provides personal care and 24 hour support to people in their own homes, many of whom suffer from conditions such as neuro muscular disorders and other various physical disabilities. The people who use the service are mainly young adults. The office is located in Salford Quays, Greater Manchester.

We carried out our inspection of Care Preference on 28 September 2015. At the previous inspection in September 2013, we found the service was meeting each of the standards assessed.

There was a registered manager in post. 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.

During the inspection we found three breaches of regulation with regards to Fit and Proper Person Employed, Good Governance and Staffing. We are currently considering our enforcement options in relation to these breaches.

We checked to see if staff who were employed by Care Preference had been recruited safely and looked at nine staff recruitment records. Of the nine files we looked at, four of them did not have appropriate Disclosure Barring Service (DBS) checks in place. Another two of the files contained DBS checks that had been received after staff had commenced employment. We also found that eight of these members of staff did not have two references in place before they commenced employment. The recruitment policy and procedure stated that new recruits must have a DBS check and two references in place before they could start working with vulnerable people. This is a breach of Regulation 19 (2) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to fit and proper persons employed.

We checked to see what training staff had available to them to support them in their role. We did not see any evidence that staff were trained in subjects such as safeguarding, infection control, moving and handling or health and safety. The manager said that when new staff started they were asked to read various policies and procedures, but that no formal training was provided as part of their initial induction or on going development. The manager also said that they undertook ‘Competency’ assessments to ensure that staff had the correct skills to undertake their role. However, we were not shown evidence that these competency checks were undertaken on a regular basis, for each member of staff. This is a breach of Regulation 18 (2) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 with regards to Staffing.

We asked the manager what Governance Systems were in place to ensure the quality of service was being monitored effectively. We were told that ‘Pop Ins’ and ‘Competency Checks’ were undertaken to ensure that staff were working to a high standard and that things were being done correctly. We were unable to see that these checks were undertaken on a regular basis for each member of staff. The manager said these had been the responsibility of a previous member of staff who had now left the company.

The manager said that no other formal auditing processes were in place to ensure good governance, which would cover areas such as staff recruitment, medication, staff training and infection control. This meant that if there were concerns in these areas, the manager would be unaware, because regular quality assurance checks were not being undertaken. This was a breach of Regulation 17 (2) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in relation to Good Governance.

People who used the service were central to the recruitment process and were able to state if they were comfortable with certain members of staff looking after them before staff were employed.

The people we spoke with told us they felt safe as a result of the support they received from staff at Care Preference.

People said they received their medication at times they needed them, which gave them an increased feeling of safety as a result.

We looked at how the service managed risk. We found individual risk assessments had been completed for each person and recorded in their support plan. There were detailed management strategies to provide staff with guidance on how to safely manage risks and also ensure people’s independence, rights and lifestyle choices were respected.

We looked at how the service ensured there were sufficient numbers of staff to meet people’s needs and keep them safe. Each person who used the service had their own rota in place which identified which staff would be supporting them on each day. The people we spoke with said there were sufficient staff available to support them. Additionally, they told us that the ‘on call’ arrangement made them feel safe, knowing that other staff would be available to provide their care at short notice.

The Mental Capacity Act 2005 (MCA 2005) sets out what must be done to make sure the human rights of people who may lack mental capacity to make decisions are protected. The Deprivation of Liberty Safeguards (DoLS) provides a legal framework to protect people who need to be deprived of their liberty to ensure they receive the care and treatment they need, where there is no less restrictive way of achieving this. At the time of the inspection, there was nobody using the service who was subject to a Deprivation of Liberty Safeguards.

Staff who worked for Care Preference were required to provide support to people in order to ensure they received proper nutrition. Some of the people we spoke with said they were unable to prepare their own food, but that they were given the opportunity to go to local shops and chose the kinds of food they liked. They also said they could be present in the kitchen during food preparation, to ensure the food was cooked to their liking.

There was a complaints procedure in place. We looked at the complaints log and saw complaints had been responded to appropriately, with a response given to the individual complainant.

The staff we spoke with were positive about the leadership of the service.