About the service:

Serenity Always Health Care is a domiciliary care service that provides personal care to people living in Wolverhampton and Telford, Shropshire. At the time of our inspection visit, the service was providing personal care support to approximately 50 people.

People’s experience of using this service:

People were not protected from the risk of harm. Risks to people were not being assessed and planned for and staff did not have guidance on how to care for people safely. The provider had not deployed safe systems of care to manage people’s medicines. Records of incidents and accidents were not kept and we could not be sure action was taken to reduce the risk of re-occurrence.

Staff could identify the signs of potential abuse and reported any concerns to the provider. However, the lack of incident records meant we could not be sure the provider had referred any concerns to the local authority safeguarding team when needed.

Staff had not received sufficient training or supervision to ensure they could deliver safe and effective care. The provider did not provide effective guidance for staff on the safe administration of people’s medicines, or monitor their practice to assure us that people received their medicines as prescribed.

We could not be sure people were supported in the least restrictive way possible. The provider did not follow legal requirements when people lacked the capacity to make certain decisions. People had not signed to consent to their care and were not always consulted on how they wanted to receive their care. Care plans were not personalised and did not reflect people’s diverse needs. The provider was not identifying and meeting the information and communication needs of people with a disability or sensory loss.

There was a lack of oversight of the service and the provider had not developed a systematic approach to quality assurance to identify shortfalls and drive improvements. People and relatives knew how to complain but did not always feel confident their concerns would be listened to or acted on. The provider had sought feedback on how the service could be improved but could not demonstrate that this was acted on.

Staff treated people with kindness and respect, but sometimes felt staff were rushing to finish their care and did not always have time to provide emotional support. There were not enough staff to meet people's needs and keep them safe at all times. The provider needed to recruit additional staff to ensure they could respond to unplanned absences. The provider followed recruitment procedures to ensure staff were suitable to work with people.

People were supported to access health care services when they needed to and staff ensured people had choice when they supported them with meals.

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

Rating at last inspection:

The service was rated as Good in all key questions (published 10 December 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection. We found concerns during the inspection and there were breaches in regulations. We rated the key questions safe, effective, responsive and well led as Inadequate. The key question caring was rated Requires Improvement. The overall rating was Inadequate.

Enforcement:

You can see the action we told provider to take at the end of the full report.

Follow up:

As we have rated the service as inadequate, the service will be placed in 'special measures'. Services in special measures will be kept under review and, if we have not already taken immediate action to propose to cancel the provider's registration of the service, it will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe, so that there is still a rating of in

The inspection took place on 20 October 2016 and was announced. Clarriots Care Wolverhampton provides personal care to people living in their own homes. At the time of the inspection 16 people were receiving a service from the provider. This was the location’s first inspection since they were registered in May 2015.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 felt safe. Staff understood their responsibilities in identifying and reporting potential abuse. Risks had been assessed and were managed with the aim of protecting people from avoidable harm. The provider had systems in place to ensure only suitable staff were recruited to work with people. People received their medicines as prescribed with support from trained staff.

People and their relatives told us staff had the skills and knowledge required to meet their needs. Staff received training relevant to their role. People were asked for their consent before care and support was provided. People who received support to maintain their diet were happy with the food and drink provided. Staff knew how to respond to changes in people’s healthcare needs and people were supported to access relevant healthcare services when required.

People and their relatives told us the staff who supported them were friendly and caring. People were supported to make their own decisions about their care and support. Staff supported people in a way that upheld their privacy and dignity and where possible, promoted independence.

People and their relatives were involved in the planning and assessment of their care and support. People were supported by staff who understood their needs and preferences. People knew who to contact if they were unhappy about the service they received. There was a system in place to manage complaints and people received details of how to complain, when they started using the service.

People, relatives and staff told us they were happy with the service and told us they felt it was well managed. Staff felt supported by the registered manager and provider and were able to share their views, ideas and concerns. There were systems in place to monitor the quality of the service provided and people had been asked to give feedback about the service they received.