Background to this inspection
Updated
9 March 2016
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 service was 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 inspection took place on 30 November 2015 and was announced. The service was given 48 hours’ notice of our inspection because the location provides a domiciliary care service and we needed to be sure that someone would be at the agency office who could assist us with this inspection.
The inspection was undertaken by two adult social care inspectors. Before this inspection we reviewed the information we held about the service, such as notifications we had received from the registered provider and information we had received from the local authority who commissioned a service from the agency. The registered provider submitted a provider information return (PIR) prior to the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection we spent time with two people receiving services in their own home. We interviewed two care workers at the office and we spoke with the registered manager and the service manager. We looked at records which related to people’s individual care; this included the care planning documentation for two people and other records associated with running a community care service. We also looked at two care workers recruitment and training records, the care worker rotas, records of audits, policies and procedures and records of meetings.
Updated
9 March 2016
We undertook an announced comprehensive inspection on Monday 30 November 2015. We gave the provider 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service and we needed to be sure that someone would be at the agency office that could assist us with the inspection. The registered provider first registered this service with the Care Quality Commission on 29 April 2015 and this was the first inspection for this location.
This domiciliary care service is registered to provide personal care for people with a range of varying needs including dementia, learning disabilities or autistic spectrum disorder, mental health, older people, people who misuse drugs and alcohol, people with an eating disorder, physical disability, sensory impairment and younger people who live in their own homes. At the time of our inspection eight people received a personal care service.
The registered provider is required to have a registered manager in post and on the day of this inspection there was a registered manager registered with the Care Quality Commission [CQC]. A registered manager is a person who has registered with the 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 who used the service told us they felt safe and we found that staff knew how to protect people from avoidable harm. Risk assessments and risk management plans were in place and they were regularly reviewed and updated in line with the person’s needs.
The service had a robust recruitment policy and sufficient numbers of staff were employed to ensure there was minimal disruption to the service people received. People had regular carers who they knew and who knew them.
People spoke positively about the care they received. It was clear from talking to people and looking at care plans that care was person centred. People told us they felt safe and we found that staff knew how to protect people from avoidable harm.
The registered provider understood the importance of risk management and had policies and procedures in place. This ensured people were safely supported to undertake daily activities and that their freedom was supported. Care workers told us how they undertook routine environmental and health and safety checks in people’s homes to help keep people safe.
We saw from peoples files how the registered provider undertook safe recruitment of staff so that only people considered suitable to work with vulnerable people had been employed; this included obtaining two references and checks with the Disclosure and Barring Service [DBS] for each employee.
Care workers had received training in managing medication. The provider had a medication policy and procedure in place. People required assistance from staff to take their medicines. Care plans included protocols for medicines which people were prescribed for specific conditions.
Care workers told us they felt well supported and we saw good communication and relationships between care workers, management, people who used the service and outside agencies such as the local authority and health workers.
We saw that a person’s religious or cultural beliefs were respected and documented and a physical health assessment was in place. More detailed assessments in care files included information about people’s physical health, their sleeping, diet and personal care needs.
Care workers had a training plan in place and we saw how this was managed and recorded electronically to ensure that they had the up to date skills they needed to carry out their duties effectively. Competencies were annually reviewed. Training included mandatory areas such as safeguarding, moving and handling, medicine management and health and safety.
Care workers we spoke with had a good understanding of the Mental Capacity Act 2005 [MCA] and Deprivation of Liberty Safeguards [DoLS]. People receiving care and support were encouraged to make their own decisions and we saw care was delivered with their consent and understanding.
The registered manager was a dignity in care champion. This reflected on the service we saw in people’s homes where care workers delivered compassionate care with dignity and respect to people whilst maintaining their confidentiality.
People told us that the service was responsive to their needs. We saw that care plans were person centred and focused on the individual needs of the person being supported. They included people’s preferences, likes and dislikes and all of the people we spoke with confirmed that they had been involved in discussions regarding their care.
The registered provider had a compliments and complaints policy and procedure. People said they were confident in raising concerns. Each person was given a copy of the complaints procedures. People told us that complaints were listened to and resolved Staff told us they knew how to complain and that they were confident any complaints would be listened to and acted on.
We saw from local authority feedback and care plans that the registered provider worked effectively with external agencies and other health and social care professionals to provide consistent care to a high standard for people that was responsive to their changing needs.