8 August 2017
During a routine inspection
Ark Home Healthcare provides personal care and support to adults and children in their own homes. The provider had recently notified us that they had updated their statement of purpose to include children. At the time of the inspection the provider informed us they were not supporting any children and were providing a service to 81 adults, the majority of them were living with dementia.
The service had a registered manager who was present on both days of the inspection, who had worked in the service before it was registered with a new provider. 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 told us they did not receive their visits at the times they requested and this was more noticeable during the weekends. Action was not taken by the provider when this occurred which had a negative impact on them receiving safe care. People were provided with different staff during the weekends who were not familiar with their needs. People knew what to do if they were unhappy with the service but when they contacted the office to speak about their concerns their complaints were not satisfactorily resolved. There was a system in place to log and monitor complaints, however verbal complaints were not documented.
Pre-employment checks undertaken on staff were not always robust. Staff had received an induction and planned programme of training to ensure they had the required skills and knowledge to help people with the care they required. People told us staff were kind and caring and provided support in a way that respected their privacy and dignity. People received support with their meals and medicines when this was needed. Staff had completed training in the safe management of medicines and their competency had been assessed. Healthcare services were accessed by people when they needed help with their healthcare needs and guidance was available for staff to show them how to respond and report concerns when people became unwell.
Risk assessments contained sufficient guidance to minimise the likelihood of harm to people when being supported to meet their assessed needs, and safeguarding protocols were accessible for staff to follow when they suspected people were at the risk of abuse. Care records were personalised to meet people’s individual needs and preferences, these were in the process of being rewritten to align with the provider’s new procedures. Procedures and guidance in relation to the Mental Capacity Act 2005 (MCA) was followed which included steps that the provider should take to comply with legal requirements. People had access to advocacy, advice and resources to support them with dementia care. This ensured people’s views and wishes were heard and enabled them to maintain their independence. Information was available in an accessible format so they could better understand the services they received.
People had mixed opinions about how the service was run. Their views and experiences had not been sought through the use of surveys as the provider had only been in operation since May 2017, but checks had been carried out in some people’s homes to assess the quality of care. Systems of audits were in place, however they did not operate effectively to monitor the quality of the service and identify the issues we found. Staff spoke positively about the training they received and the overall management of the service. The provider worked in partnership with other services to help deliver continuous care and sought new ways to engage with their workforce to help deliver better care.
We found four breaches of regulations relating to the management of risks to people’s health and welfare, staff recruitment, receiving and acting on complaints and good governance. You can see what action we asked the provider to take at the back of the full version of this report.