Background to this inspection
Updated
1 March 2019
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
An adult social care inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
This service is a domiciliary care agency which provides personal care to people living within their own homes. It delivers a service to adults and children with a wide range of complex needs.
At the time of the inspection, 45 people were supported but the service.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.’
Notice of inspection:
We gave short notice of one working day to ensure someone was in the office.
What we did:
Before the inspection:
We used information the provider sent us in the Provider Information Return. (PIR) This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We looked at information we held about the service including notifications they had made to us about important events. We also reviewed all other information sent to us from other stakeholders for example the local authority and members of the public.
During the inspection:
Inspection site visit activity started on 21 January 2019 and ended on 29 January 2019. We visited the office location on 21 and 24 January 2019 to see the manager and office staff; and to review care records and policies and procedures.
We spoke to or visited five people using the service and nine family members to ask about their experience of care. We also spoke with the registered manager, the complex care manager, the nurse assessor and five members of staff.
We sought feedback from professionals whom used the service such as community nurses, social workers and case managers.
We looked at ten people’s care records and a selection of medication and medication administration (MARs). We looked at other records including quality monitoring records, training records, recruitment records for five staff and documents highlighting checks carried out on the service delivery, staff competence and equipment.
After the inspection:
We reviewed information sent by the registered manager to collaborate discussions held on inspection.
Updated
1 March 2019
About the service: Jane Lewis Health and Social Care is a Domiciliary Care Agency which provides clinically-specialised care packages to children and adults with complex healthcare issues.
People’s experience of using this service:
People and families told us the staff were kind, compassionate and respectful towards them. They described how they trusted and felt safe with the staff. The management team and staff had developed strong relationships with people and family members and were described as ‘going that one step further’ in order for them to have an improved quality of life.
People had had the opportunity to choose their own staff and ensure that they were compatible. Family members told us they had become reliant on the staff, had full confidence in them and they were more like friends.
People were supported to have maximum choice and control of their lives and supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The service was exceptionally well-led. There was a visible and effective leadership team who were open and transparent. This resulted in an effectively organised, supportive and well managed service. Professionals told us they continued to return to the service for new support packages as they had “Every confidence” in them and they would “Think outside of the box” to make things happen.
The registered manager demonstrated how their robust quality assurance systems had sustained continual development and improvement at the service. They had demonstrated innovative ways of working that ultimately improved the outcome for people and families they supported. They were clear about their expectations relating to how the service should be provided and led by example. Since the last inspection, they had made many positive changes and were driven to provide an outstanding service. They were supported by support workers and a management team who were passionate and fully committed to delivering quality person-centred care to people. Morale was high within the service.
People and families were extremely complimentary about the support provided and told us how they had been able to maintain wider family relationships, work, education and social lives. A very person centred approach had been adopted in the assessing, planning and delivery of people’s care and support. This took into account all aspects of a person’s health and wellbeing. Care plans were extremely detailed and informative yet highly personal. They identified positive outcomes for people.
Staff were highly skilled, motivated and knowledgeable. They provided flexible care and support in line with a person’s needs and wishes. The staff team was consistent and people achieved positive outcomes which exceeded expectations. People were able to live in their own homes and maintain personal or family relationships. Staff worked alongside other family members and professionals to provide a better quality of life for people in the short and long term: supporting them to develop in areas such as communication, social interaction, education and independence.
People told us they felt safe whilst being supported by staff. Families were confident that loved ones were well cared for despite known risks to their health and wellbeing. Adults and children were supported to live at home with complex health needs. Staff encouraged them to be as independent as possible whilst ensuring they remained safe and well. There was a proactive approach to assessing, anticipating and managing risk which allowed people to remain safe.
People were encouraged and supported to take positive risks so the restrictions on their own or family life were kept to a minimum.
Medicines were managed safely and people received medication at the right time.
Rating at last inspection: The service was rated good on 5 May 2016.
Why we inspected: This was a planned inspection based on the rating at the last inspection.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.