Archived: Somerset Care Community Services (Wiltshire)

Updated 15 May 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 comprehensive inspection took place on 24, 25 and 30 January 2018. This inspection was announced, which meant the provider was given 48 hours’ notice of the inspection. This was because the location provides a domiciliary care service. We wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf.

One inspector and two experts by experience carried out this inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The inspector visited the office on 24, 25 and 30 January 2018, while the experts by experience supported the inspection on 25 January 2018 and completed telephone interviews with people and their relatives.

During our last comprehensive inspection in December 2015 we identified the service was not meeting two of the regulations, one for the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one for Care Quality Commission (Registration) Regulations 2009.

Before the inspection we checked the information we held about the service and the service provider. This included statutory notifications sent to us about incidents and events that had occurred at the service. A notification is information about important events relating to the care they provide which the service is required to send to us by law. We also looked at previous inspection reports. We reviewed the Provider Information Return (PIR) from the service. This 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 looked at documents relating to people’s care and support and the management of the service. We reviewed a range of records which included six care and support plans, staff training records, staff personnel files, policies and procedures and quality monitoring documents.

We spoke on the telephone with 30 people who used the service and 13 relatives about their views on the quality of the care and support being provided. We spoke with the registered manager, regional manager, registered nurse, customer and staff supervisor and five care and support staff.

We asked for feedback from seven social care professionals. We had no response.

Updated 15 May 2018

Somerset Care Community Services (Wiltshire) provides domiciliary care and support services to meet a wide range of individual needs, including older people, individuals with physical disabilities, and people living with dementia. At the time of our inspection 378 people were being supported by this service.

This comprehensive inspection took place on 24, 25 and 30 January 2018. This inspection was announced, which meant the provider was given 48 hours’ notice of the inspection. This was because the location provides a domiciliary care service. We wanted to make sure the manager would be available to support our inspection, or someone who could act on their behalf.

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 our last inspection in December 2015, we identified two breaches of the regulations, one for Care Quality Commission (Registration) Regulations 2009 and the other of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because incidents that required reporting to the police, had not been notified to the Commission and a referral had not been made to an external regulator following a safeguarding investigation.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question of well-led to at least good. During this inspection we found improvements had been made and the provider was notifying us of important events as per regulations.

The medicine administration records did not always show people’s medicines were safely managed. This was because staff didn’t always sign that they had administered the medicines. Medicines audits had identified the shortfall and each staff omission was dealt with.

We received mixed feedback about the continuity of care calls. This was because the agency is a provider for the local authority’s Help to Live at Home contract. The contract specifies that people were not allocated a specific time, but time slots. This meant people did not always know when staff would visit.

People told us they felt save when carers visited them in their homes. Relatives confirmed they had no concerns regarding the safety of their family member.

Staff had the knowledge and confidence to identify safeguarding concerns and act on them to protect people. They had access to information and guidance about safeguarding to help them identify abuse and respond appropriately if it occurred.

The service developed safety packs to promote people’s safety in their own homes. This provided people with information for example about fire safety, extreme weather, financial well-being, keeping strangers out and fighting doorstep crime.

Risks associated with people’s mobility, eating and drinking, domestic tasks, environment and fire, had been identified. Records showed actions required to promote safety had been taken.

People were supported by staff who had access to a range of training to develop the skills and knowledge they needed to meet people’s needs. People told us they felt staff were skilled to meet their needs.

People told us they were happy with the care they received. Speaking with relatives they praised the care their family member received.

People were treated with kindness and compassion in their day to day care and support. Staff showed concern for their well-being in a caring and meaningful way.

People’s support plans were clearly written and we saw evidence that people and/or their relatives were involved in the development of the plan.

The service had identified that some people could be socially isolated at home, finding it difficult to access the community. The registered manager told us they had compiled an information pack full of activities available for people within their local area.

The registered manager told us they valued their staff and wanted the service to be a place where staff enjoyed coming to work. Staff spoke positively about the support they received.

The registered manager continually looked at innovative ways of improving the service and getting people involved. They had made various links with agencies in the community.

There were systems in place to monitor and assess the quality of the care provided. Audits were completed and any shortfalls identified were dealt with.

We have made a recommendation that the service monitors the timing of people's support.