About the service:

Vitalitycare and Support services is a domiciliary care service which is registered to provide personal care to people living in their own homes. At the time of inspection, 19 people were receiving care and support services.

People’s experience of using this service:

Statutory notifications relating to two separate allegations of abuse had not been submitted to CQC as required.

People told us they felt safe. However, we found that where allegations of abuse had occurred, these had been dealt with internally to ensure people were safe but they had not been escalated to the local authority as per the provider’s own and the local safeguarding policy. Risks to people had been assessed and staff had a good understanding of these risks and how to minimise them. People received their medication as prescribed. Staff demonstrated a good knowledge of types and signs of abuse and how to report concerns of abuse.

People were supported by staff who had the skills to meet their needs. People’s consent was sought before providing support. Staff demonstrated a good understanding of the Mental Capacity Act 2005 and what this means for people. People’s nutritional needs were met and people were happy with the support they received. People had access to healthcare professionals when required.

People told us staff were kind and caring in their approach. People’s independence was maintained and encouraged. People’s privacy and dignity was respected. People were communicated with in their preferred way.

People’s needs were assessed and reviewed on a regular basis with them and their family. People’s care records were person centred and included their likes, dislikes and personal history. People and relatives felt confident raising concerns and where complaints had been raised, they had been dealt with appropriately.

The provider had made improvements in relation to their quality assurance systems and actions had been implemented as a result of errors being identified. Staff, people and relatives spoke positively about the registered manager and provider.

Rating at last inspection:

At the last inspection the service was rated Requires Improvement (25 October 2017). The rating of this service has remained the same. This is the second time that the service has been rated as requires improvement.

Why we inspected:

This was a planned inspection which took place on 22 and 23 January and 05 February 2019. At the last inspection the service was not meeting the regulations and they were required to send us an action plan.

Enforcement:

Full information about CQC’s regulatory response to the more serious concerns found in inspections is added to reports after any representations and appeals have been concluded.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection took place on 7 and 15 September 2017 and was announced.

Vitalitycare and Support Services is registered to provide personal care to people living in their own homes. There were 18 people using the service on the day of our inspection.

The service is required to have a registered manager and there was a registered manager in post at the time of our inspection.

The provider had not carried out consistent pre-employment checks on prospective staff to ensure they were suitable to provide care and support to people in their own homes. The information recorded on people’s medication administration records was not clear, accurate or complete. The provider’s quality assurance processes were not adequately developed, and not as effective as they needed to be.

Staff had received training in, and understood, how to recognise, respond to and report abuse. The risks to people had been assessed, reviewed and plans put in place to keep people safe. People received a consistent and reliable service from staff with whom they were familiar.

The provider’s induction training did not incorporate the requirements of the Care Certificate. Staff benefited from a rolling programme of training and periodic one-to-one meetings with the management team. People’s rights under the Mental Capacity Act were understood and promoted by the provider and staff team. Where people needed support to prepare meals, staff provided this on a consistent basis and in accordance with their wishes. Staff monitored any changes in people’s general health, and helped them request professional medical advice and treatment when needed.

Staff took a caring and compassionate approach towards their work with people. The provider encouraged people’s views and involvement in decisions about their care and support. People's rights to privacy and dignity were protected by staff.

People received personalised care and support. People’s relatives contributed towards care planning and the resulting care plans were followed by staff. People and their relatives knew how to complain about the service, and felt confident they would be listened to.

People and their relatives had open communication with the management team. Staff felt well-supported in their job roles, able to approach the management team at any time, and were clear what was expected of them.