Beckside Court, known as Locala Homecare, is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It provides a service to older adults, including people living with long term conditions including frailty and dementia, who require ongoing support, support after a discharge from hospital and short term support while waiting for another provider. At the time of this inspection, 89 people were being supported by the service and were in receipt of the regulated activity, ‘personal care’.

People's experience of using this service:

¿ People and their relatives told us staff were caring and provided a service that made them feel safe, promoted their independence and had a positive impact in their lives.

¿ We found that the service had deteriorated in some domains since our last inspection. However, the domains relating to caring and effective have remained the same.

¿ The service met the characteristics of requires improvement in three out of the five key questions.

¿ We found two breaches of the regulations. One breach in relation to good governance because of lack of consistency in the quality of records relating risks to people’s care, support required and their consent. Management's oversight has not always been robust in how risks to people and medicines were managed by the service. We found a second breach because the provider failed to notify the CQC of safeguarding incidents.

¿ The management of risks was not always consistent. We found known risks to people’s care were not always identified in their risk assessments.

¿ Medicines were not always managed safely. The provider had identified in their internal audits that this was an area that required improvement and actions were being taken to address the issues. We made a recommendation about medicines.

¿ The provider had several systems in place to monitor the quality of the service but their effectiveness was not always consistent. The provider had identified some areas that required improvement however, other areas such as the recording and monitoring of risk associated to people’s care and the lack of submission of statutory notifications had not been identified before this inspection.

¿ The service had a registered manager in place but the day to day running of the service was the responsibility of the business manager. We found management’s oversight of accidents and incidents and compliance with legal requirements was not always robust.

¿ Most people and relatives told us care was provided by a regular team of staff.

¿ People and relatives told us they had been involved in setting up and reviewing their care and were confident that any concerns raised to the provider would be appropriately acted upon.

¿ Staff told us they enjoyed their job and most of them felt well supported through regular supervision and assessments of their competency and training.

¿ The provider had developed several links with the community and partnerships to support care provision and service development.

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

Ratings at last inspection:

At our last inspection the service was rated good overall. Our last report was published on 16 September 2016.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Enforcement:

Information relating to the action the provider needs to take can be found at the end of this report.

Follow up:

We will continue to monitor the service to ensure that people received safe, high quality care.

Further inspections will be planned for future dates. We will follow up on any breaches of regulations at our next inspection.

This inspection took place on 10 August 2016 and was announced. The service had been registered with the Care Quality Commission since May 2013 and had previously been inspected during November 2013, when the service was found to be compliant in all areas inspected.

Locala homecare of Beckside Court provides domiciliary care services to people in their own homes. The people who receive these services have a wide range of needs.

The service had a registered manager in post at the time of our inspection. 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.

People and their relatives told us they felt safe and staff had received safeguarding training in order to keep people safe. There were enough staff to meet people’s needs with a regular, consistent staff team and there were robust recruitment practices in place, which meant staff had been recruited safely. Risks to people and staff had been assessed and reduced where possible.

The recording of the administration of medicines had not been accurate. Records did not provide a clear and accurate account of the medicines people had been administered by staff. This had been addressed prior to the inspection and a review of medicines management was taking place.

People received effective care and support to meet their care and support needs. People and their relatives felt staff had the necessary skills and training to provide effective care and support. Staff told us they felt supported and we saw staff had received induction and training. Staff received ongoing supervision and appraisal.

We saw from the care files we reviewed consent had been sought and obtained from people, prior to their care and support being provided.

People and the relatives we spoke with told us staff were caring. The staff we spoke with were enthusiastic and were driven to provide good quality care. Staff told us how they respected people’s privacy and dignity and the people we spoke with confirmed this. People were encouraged to maintain their independence.

Care support plans were detailed and personalised, taking into account people’s choices and preferences. People had been involved in their care planning and told us they felt they could make their own choices. Some people received support to continue enjoying activities that were important to them, in the local community.

All of the people, relatives and staff we asked told us they felt the service was well led. Regular quality assurance checks and audits took place. Staff felt supported and people felt able to contact the office in the knowledge they would be listened to.

Due to business growth, recent changes had taken place in terms of the structure of the organisation. People and staff felt this was effective. The head of operations was supported by a wider team and had developed a growth strategy to support the growing organisation.

During our visit, we spoke with the manager, care co-ordinator, a care worker, one person who used the service and a relative.

Feedback from people who used the service and their relative was positive. People told us they were very happy with the care they received. The people we spoke with told us the carers arrived on time and stayed for the allocated amount of time.

People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

There was a lone working policy and risk assessments in place to ensure staff were kept safe. There was a complaints procedure in place and people knew how to make a complaint.