Archived: Interserve Healthcare Liverpool

Updated 10 November 2018

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 9 and 11 October and was announced. The registered provider was given 48 hours' notice because we needed to be sure that someone would be available at the office. The inspection was conducted by one adult social care inspector.

Before our inspection we reviewed the information we held about the service. This included the statutory notifications sent to us by the provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law.

The provider had submitted a provider information return (PIR) with information about the service and feedback from CQC' questionnaires. We also contacted the commissioners of the service.

We used all of this information to plan how the inspection should be conducted.

During the inspection we spoke with the registered manager, a client manager, a branch nurse, a care coordinator, a care assistant and a renal technician who had worked for the provider for a long time in different roles.

We also spoke with three people who used the service and two relatives. In the report we talk about “branch staff” and “field staff”. “Branch staff” were based at the service’s central office in Liverpool. They reached out from there to provide support to people who used the service, relatives and staff, by phone, email or in person. “Field staff” were care professionals and nurses who directly provided personal and nursing care to people in their own homes.

We looked at the care records of four people receiving support from the service, four staff recruitment records, medicine administration records (MAR) and other records relevant to the quality monitoring of the service.

Updated 10 November 2018

The inspection took place on 9 and 11 October 2018. The inspection was announced.

Interserve Healthcare Liverpool is a domiciliary care agency providing nursing and personal care to adults and children in their own homes. At the time of the inspection the service was directly managing the provision of care to 12 adults and 14 children.

The service had a registered manager. A registered manager is a person who has registered with CQC 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.

The service had since our last inspection merged with another branch and now also provided care services to people in the Lancashire and Fylde area.

During the previous inspection we found the service was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because people were placed at risk of receiving unsafe care as some care plans were lacking in detail.

During this inspection we found the service had made the necessary improvements. Staff had added more detail to care plans. The branch had introduced a review of care plans as a team, to ensure the information was clear to all readers. We discussed with the branch nurse and registered manager that aspects of people’s ‘as required’ medicines would benefit from a similar review to ensure clarity.

During the inspection we were given access to the electronic records relating to the service which included evidence of quality audits.

As part of our inspection we checked three people’s medication administration records (MAR). We found that staff had sent completed MAR for review by nurses. However, two people’s MAR we checked had not been reviewed until several months after completion. An audit had identified some outstanding records, but actions had not been completed when we inspected.

We have made a recommendation regarding the service’s keeping and auditing of records.

People and relatives we spoke with told us they overall had no concerns and had confidence in the staff providing care. A person and a relative we spoke to were concerned about arrangements, if their current staff should become unavailable. The registered manager was able to tell us about their contingency plans.

Staff we spoke with had no concerns about the service. Staff explained to us their role and responsibilities regarding safeguarding people who used the service. Staff were confident that any concerns they had would be dealt with by branch staff and the registered manager. The registered manager managed accidents and incidents appropriately.

The service had two dedicated care coordinators ensuring the safe recruitment of staff. Branch staff planned who would provide care to people months in advance, to help identify gaps. This identified vacancies which the provider was recruiting for when we inspected. The provider had effective recruitment, supervision and training processes in place to ensure the staff were safely able to support people using the service.

Care plans showed the service always sought people’s consent before providing support. Staff were knowledgeable about the Mental Capacity Act. The registered manager had written to social workers where a person using the service had transitioned from child to adult services, to ensure the appropriate authorisations were sought.

The service worked with other health professionals to provide effective care for people. We saw that professionals from hospitals had been involved in writing specific care plans for people.

Staff we spoke with talked about people who used the service in a caring way, showing understanding and knowledge of things important to people. People and relatives we spoke with told us about the caring, engaging nature of the regular staff teams.

Relatives told us they were involved in the planning of their loved one’s care. Branch nurses regularly visited people to review and reassess their needs. Spot checks focused on the interactions staff had with people, to ensure staff provided kind, quality care.

People and relatives told us they knew how to make a complaint. The service carried out quarterly surveys. The registered manager had responded to people’s comments to let them know how they would improve.

We saw that the service recorded complaints, but also conversations about improvement needs, to ensure they were followed up.

The registered manager was supported by a management team with responsibility for assessment, development of care plans, staff coordination and contact with people who used the service. The provider’s quality specialists completed regular audits and provided additional oversight of the service.

Staff we spoke with told us that they were happy in their jobs and that managerial staff based at the branch quickly helped them with any problems. The registered manager was introducing teleconferences for staff to dial into, to include more staff in team meetings.

Care plans promoted a culture of care that was dignified and respectful. Staff were knowledgeable about people’s different communication needs and the service used an interpreter for example to make information accessible for relatives.

The registered manager had notified the Care Quality Commission (CQC) of events and incidents that occurred in the home in accordance with our statutory notifications. This meant that CQC were able to monitor information and risks regarding the service.

Ratings from the last comprehensive inspection were on display as required.