Background to this inspection
Updated
13 April 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 service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service for people living with dementia, mental health and older people. In addition they support people who have a physical disability and younger adults.
We gave the service 48 hours’ notice of the inspection visit to ensure we had access to the office base and because we needed to be sure that they would be in.
The inspection team on the day consisted of 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.
The inspection site visit was on 01 March 2018. It included an on-site office visit. We visited two people in their home who received a service, telephone interviews with people who used the agency and relatives. We visited the office location on 01 March 2018 to see the management team and to look at care records of people.
Prior to this inspection, as part of our planning, we reviewed all the information we held about the service, including data about safeguarding and statutory notifications. Statutory notifications are required to be submitted by the provider to the Care Quality Commission to advise of important events.
We received information from the local authority about the care people received. This helped us to gain a balanced overview of what people experienced when accessing the service.
We used information the provider sent us in the Provider Information Return. 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.
During the inspection, we spoke with four people who used the service and eight carers/relatives of people. We also spoke with the registered manager, manager, senior carer and five support workers. We looked at the care records of two people who used the service and training and recruitment records of two staff members.
In addition we looked at records related to the management of the service and medication records. We did this to ensure the management team had oversight of the service and they could respond to any concerns highlighted or lead the agency in ongoing improvements. We also looked at staffing levels focusing on how staff provided care within a geographical area.
Updated
13 April 2018
This inspection visit took place on 01 March 2018 and was announced. The provider was given 48 hours’ notice because the service delivered domiciliary care to people who lived in their own homes. We needed to be sure staff in the office and people the service supported would be available to speak to us. This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. For example it provides a service to older people, people with physical disabilities and people with mental health needs. At the time of our inspection there were 17 people receiving a service from the agency.
At the last inspection in June 2016 we asked the provider to take action to make improvements because breaches of legal requirements were found. The provider had failed to ensure there
were effective systems in place to monitor the safety and quality of all aspects of the service.
At this inspection visit carried out on 01 March 2018 we have rated the service Good.
During this inspection we found the management team had addressed the issues and had implemented systems to ensure people were safe. For instance we looked at how the service protected people from avoidable harm. We found risk assessments were now more robust and completed as part of people's care plans.
During this inspection, we found the management team completed a range of quality audits including improvement of auditing medication processes. These were now taking place monthly. Any issues found on audits were quickly acted upon and any lessons learnt to be implemented to keep people safe.
A new system was now in place for the administration and recording of medicines. Staff we spoke with told us it was much better and more accurate. One staff member said, “It is a really good system much more accurate with little chance of mistakes.”
We looked at care records of two people we visited in their home. Care records had been improved and were now informative and organised so staff could identify what support and tasks were required for the person.
People who used the service and their relatives/carers told us staff were caring and kind towards them. Staff we spoke with understood the importance of high standards of care to give people meaningful lives.
The management team deployed sufficient staffing levels to provide support people required in their own homes. There was evidence by talking with people who used the service and relatives they found staff showed concern for people’s wellbeing. They responded quickly when people required their help.
The service had systems in place to record safeguarding concerns, accidents and incidents and took necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.
We found there was an appropriate skill mix of staff to ensure the needs of people who used the service were met. New staff worked alongside experienced staff members and shadowed them to ensure they understood their role in people’s homes.
The management team planned visits to allow staff members enough time to reach people and complete all allocated tasks safely.
Care plans were organised and had identified the care and support people required. We found they were personalised and informative about care people received. They had been kept under review and updated when necessary. They reflected any risks and people’s changing needs.
Where appropriate in people’s care plans, meals and drinks were prepared for them. Staff had received food and hygiene training to ensure they were confident when preparing meals in people’s homes.
Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.
People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
People supported by the agency told us staff and the management team who visited them were polite, reliable and professional in their approach to their work.
People who used the service and their relatives knew how to raise a complaint and who to speak with. The management team had kept a record of complaints received and these had been responded to in a timely manner.
The service used a variety of methods to assess and monitor the quality of the service. These included staff meetings, spot checks in people’s homes, quality assurance visits, satisfaction surveys and care plan reviews.