Samfos Health

We checked progress the registered provider had made following our inspection on 17, 18 and 19 October 2017 when we found they were in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Regulation 13, Safeguarding service users from abuse and improper treatment; Regulation 12, Safe care and treatment; Regulation 18, Staffing; Regulation 11, Need for consent; Regulation 9, Person- centred care; Regulation 17, Good governance; Regulation 16, Receiving and acting on complaints; Regulation 20A, Requirement as to display of performance assessments. We also found omissions in the reporting of incidents to CQC as required by regulations which was a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. The overall rating for the service was 'Inadequate' and the service was placed in Special Measures.

Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that significant improvements had been made and it is no longer in breach of the regulations, rated as inadequate overall or in any of the five key questions. Therefore, this service is now out of Special Measures.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of this inspection Samfos Health was supporting eight people.

Not everyone using Samfos Health necessarily receives support with the regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager employed at the service. 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.

Staff understood what it meant to protect people from abuse. They told us they were confident any concerns they raised would be taken seriously by the registered manager.

Safe procedures were in place to make sure people received their medicines as prescribed.

There were enough staff available to ensure people's care and support needs were met. The registered

provider had effective recruitment procedures in place to make sure staff had the required skills and were of suitable character and background.

Staff were provided with an effective induction and relevant training to make sure they had the right skills and knowledge for their role. Staff were supported in their jobs through regular supervisions and an annual appraisal.

Staff understood the requirements of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered provider's policies and systems supported this practice.

People were supported to access relevant health and social care professionals to ensure they were getting the care and support they needed to best meet their needs.

Positive and supportive relationships had been developed between people, their relatives, and staff. People told us they were treated with dignity and respect.

People's care and support was planned and delivered in a way that ensured it met their needs and reflected their preferences.

People's care records reflected the person's current health and social care needs. The care records we looked at included risk assessments, which identified any risks to the person. They had been devised to help minimise and monitor the risks, while promoting the person's independence as far as possible. We saw people's assessments were regularly reviewed with the person on their representative.

There was an up to date complaints policy and procedure in place. People's comments and complaints were taken seriously, investigated, and responded to.

There were effective systems in place to monitor and improve the quality of the service provided.

People, their relatives and staff told us the registered manager and service manager were supportive and approachable.

People, their relatives and staff were asked for their opinion of the quality of the service via regular meetings and satisfaction surveys.

The service had up to date policies and procedures which reflected current legislation and good practice guidance.

The service was well-led. However, we need to see these recent improvements have been sustained over time in order to give a rating of good in the key question of well-led.

The five questions we ask about services and what we found