Background to this inspection
Updated
8 June 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This was a comprehensive inspection and took place on 02 May 2018. The inspection team consisted of one adult social care inspector and an assistant inspector from the Care Quality Commission (CQC). There were seven people receiving support at the time of our inspection.
We gave the registered manager 48 hours' notice of the inspection visit because the location provides care to people in their own homes and we needed to be sure the registered manager would be available to facilitate our inspection.
Before commencing the inspection we looked at any information we held about the service. This included any notifications that had been received, whistleblowing or safeguarding information sent to CQC and the local authority. A notification is information about important events, which the service is required to send us by law.
We reviewed the information the provider sent us in the Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.
Whilst undertaking our inspection visit, we looked at three care records which related to people's individual care needs. We viewed five staff files and looked at recruitment process, training, competency assessments, and supervision and appraisal records. We also looked at records associated with the management of the service which included; policies and procedures, spot checks, meetings and the complaints process.
During our inspection visit, we spoke with the registered manager, provider and deputy manager. We also visited a person and their relative in their own home to ascertain their experience of the quality of the service provided. Following our site visit, we contacted one person and two relatives of people receiving support by telephone. We also spoke with three care staff and a health professional. We used this information and previous inspection findings to inform our inspection judgements.
Updated
8 June 2018
The inspection took place on 02 May 2018 and was announced.
The service is a domiciliary care agency. It provides personal care to people living in their own homes in the Wigan and surrounding area. It provides a service to children, younger and older adults who may have a physical or learning disability and people living with dementia.
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. At the time of this inspection, seven people were receiving homecare support from A1 Nursing & Homecare Agency Limited.
A1 Nursing & Homecare Agency Limited in addition to providing homecare also provides nursing and support cover to care homes and other agencies. This was not looked at as part of this inspection.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
The service had a registered manager in post. 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.
The registered manager was available throughout the inspection but it was the deputy manager who facilitated the inspection and they told us they would be applying to become the registered manager as they oversaw the homecare packages currently.
At this inspection we found comprehensive risk assessments were in place and support plans devised to mitigate the risks. We saw that people or their relative had been involved in planning the care provided.
The provider had appropriate systems and procedures in place which sought to protect people who used the service from abuse. Staff demonstrated a good understanding of local safeguarding procedures and how to raise a concern.
The recruitment procedures ensured appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service.
Medicines were managed safely and there was no omissions in signatures on the medicine administration records (MAR) which showed medicines had been given as prescribed.
Staff received an induction, appropriate training and additional specialist training to meet the needs of the person they supported.
People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met.
People told us staff were caring and friendly and respected their privacy and dignity.
The provider had a complaints procedure in place to ensure that people and their families were able to provide feedback about their care and to help the service make improvements where required.
The provider sent a newsletter to people to maintain communication and provide updates regarding the service.
The deputy manager sought the views of people who used the service and their relatives by undertaking reviews. Following the inspection, questionnaires were being sent to ascertain people’s feedback regarding the quality of the service they received.
Staff spot checks and competency checks were undertaken regularly to help ensure consistent quality of care delivery.