30 November 2015
During a routine inspection
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.