30 December 2014
During a routine inspection
This inspection took place on 30 December 2014 and was announced.
Havant Domiciliary Care provides personal care to people in their own homes. At the time of the inspection the service provided care to 82 people with a range of needs including those living with dementia and people who needed support due to old age frailty. This included personal care for 27 people in their own apartments at an ‘extra care scheme’ called Juniper Court where a staff team were based.
The service did not have a registered manager. 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 and associated Regulations about how the service is run. There was, however an acting manager who was in the process of applying for registration with the Commission.
People, and their relatives, said they felt safe with the staff. There were policies and procedures regarding the safeguarding of adults. Staff had a good awareness of the correct procedures to follow if they considered someone they provided care to was being neglected or poorly treated.
People gave mixed views about the reliability of the service they received. Sixty- nine per cent of those who returned a survey said care staff arrived on time and 81% said they stayed for the agreed length of time. All of the people we spoke with said staff arrived on time.
People were supported by staff to take their medicines but there were numerous omissions where staff had failed to record if they had administered medicines to people. Where the provider had noted these omissions in its monitoring process sufficient action had not been taken to check people were receiving their medicines.
Checks were carried out on newly appointed staff so that people received care from staff suitable to work with them. People were supported by staff who were well trained and motivated to provide a good standard of care.
People had agreed and consented to their care. Staff sought people’s consent before providing care. There were policies and procedures for the use of the Mental Capacity Act 2005 (MCA) where people did not have mental capacity to consent to their care. Not all staff were aware of the guidance regarding the MCA and a number had not received training in this.
People’s nutritional needs were assessed and they were supported with meals and drinks. Arrangements were made to support people with their healthcare needs, such as liaising with community health services and monitoring people’s general health.
People were treated with kindness and respect. People described staff as caring and considerate. Comments were made by people about how friendly staff were. All of the people who returned a survey said the care staff treated them with respect and dignity. People were consulted about how they liked to be supported so care was provided in the way they preferred.
People said they were involved in reviews of their care needs and their care was adjusted and amended to suit their changing needs and preferences. Staff were said by people to respond to any requests for changes in how their care was provided.
There was an effective complaints procedure. People said they knew how to raise any issues they had about their care and that these were addressed to their satisfaction. Complaints were investigated and responded to by the provider.
The provider used a number of methods to monitor its performance and to check people received the right care. These included people being asked if they were satisfied with their care. Checks were made that staff behaviour and performance promoted a caring and effective service. Staff demonstrated they were committed to providing a good quality service which promoted a culture of treating people as individuals. Staff knew what to do if they had any concerns about people’s welfare and safety. Systems were used by the service’s management team to monitor that care was reviewed with people on a regular basis. Sufficient action had not been taken where it was identified by the provider’s quality assurance process that staff had not recorded if people had received their medication. Where this had occurred on multiple occasions for individual people the provider had not followed this up to check these people were receiving their medicines safely.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.