Archived: Your Care and Support Norfolk

Updated 24 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by an 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.

Service and service type:

This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older adults.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

The registered manager had only been in post a few weeks prior to the inspection. The nominated individual (who represented the provider) was also new to the provider and had been in post for four months.

Notice of inspection:

We gave the service 48 hours’ notice of the inspection visit because managers are often out of the office supporting staff or providing care. We needed to be sure that somebody would be available to support the inspection.

What we did:

Before the inspection we looked at all the information that we had about the service. This included:

• Information from statutory notifications. Statutory notifications include information about important events which the provider is required to send us by law.

• Information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

• Information from professionals we contacted who were working with the service.

During the inspection:

• We spoke to the registered manager, the nominated individual, a team leader and four carers.

• We spoke to four people who used the service and six relatives.

• We reviewed nine people’s care records.

• We looked at the medicine administration records (MAR) and supporting documents for six people.

• We looked at records relating to the governance and management of the service.

• After the inspection we asked the registered manager to send us further documents which we received and reviewed.

Updated 24 May 2019

About the service: Your Care and Support Norfolk is a domiciliary care agency that was providing personal care to 65 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

• Medicines management was not based on current best practice and there was no systematic way of identifying and investigating whether people had received their medicines correctly.

• The provider had plans in place to improve the management of medicines using an electronic system.

• Not all risks to people’s safety had been consistently assessed.

• Staff understood the different types of abuse and there were systems in place to report concerns.

• There were enough staff to meet people’s needs. However, people did not always know which carers would be arriving to support them.

• There were not robust systems in place to identify when things went wrong and to improve systems to prevent things going wrong in the future.

• Staff knew people well and said they had enough information about people’s needs to support them.

• Support plans were not always consistent in the information they contained about people’s needs.

• Staff were well trained, and people were confident in their ability to support them.

• There was not always clear guidance for staff on supporting people with eating and drinking.

• The policies and systems in the service did not support supported people to have maximum choice and control of their lives.

• People told us staff were kind and caring and respected their privacy and dignity.

• There was a strong ethos of supporting people’s independence.

• The service was generally responsive to people’s needs. However sometimes people were not happy about the timing of calls or did not know who was coming to support them.

• The service had a robust complaints procedure that people were aware of.

• Systems to monitor the quality of care needed to be improved.

• We made a recommendation about systems and processes for auditing.

• The registered manager told us they were setting up new systems for the auditing of all care records.

• They were also reviewing care plans and introducing electronic recording systems to improve the quality and consistency of records.

• Staff were positive about the management of the organisation and told us they felt supported.

Rating at last inspection: This was the first inspection of this service.

Why we inspected: This was a scheduled planned inspection based on when the provider took over the location.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our reinspection schedule for those services rated requires improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.