6 August 2014
During a routine inspection
Is the service safe?
The provider had a system in place to monitor the quality of the service and ensure that people received safe care. Risk assessments included moving and handling, continence, nutrition, medication and the risk of pressure sores. Risk assessments had been reviewed regularly to reflect people's changing conditions and ensure they were cared for safely.
An effective recruitment and selection process was in place for new staff. References and checks had been carried out to make sure that people were suitable for the work they were to perform. Staff had appropriate induction and training to ensure they had the skills and competencies to care for people safely.
A person with high physical dependency needs told us they felt safe when being handled by staff from the service.
The handling, recording and administration of medicines needed improvements to make sure people received their medicines correctly and safely as prescribed by their doctor. We have asked the provider to tell us how they will make improvements.
Is the service effective?
People's health and care needs were assessed with them before they received the service. Regular reviews of care plans and quality reviews had been carried out to ensure people's needs were being met. Care plans were up to date and reflected people's current needs.
We saw examples of the service working closely with health professionals who were involved in people's care and treatment.
People had been involved in planning their care and where possible had signed to confirm their agreement with the care and treatment provided for them. Where people were unable to make complex decisions relatives had been involved to assist in making decisions that were in the person's best interests. The provider was following the principles of the Mental Capacity Act 2005.
Is the service caring?
We spoke with two people and asked their opinions about staff and the support they received. Feedback was positive. One person told us, "I like the staff they are good to me and they are all friendly and helpful. I could not have a better service." Another person said, "I can't believe that people are so helpful." A relative we spoke with told us, "Staff visit each day and I also go in daily. We have good communication. There were problems when X was discharged from hospital. We worked closely together to resolve the issues."
When speaking with staff it was clear that they genuinely cared for the people they supported. They had detailed knowledge of people's individual needs and the actions they needed to take to ensure a high quality service. Staff were keen to be involved in further training so that they had greater understanding of people's health care needs. A member of staff told us they had been involved in training relating to Parkinson's disease, dementia and catheter care.
Is the service responsive?
We saw that a copy of the complaints procedure had been included in the care information left in people's homes. The procedure stated clearly how complaints would be managed. A person using the service told us how they would make a complaint. A relative confirmed they were aware of the complaints procedure and would have no hesitation in raising any concerns they had directly with the manager or by making a complaint. The manager told us they had not received any complaints about the service since the last inspection.
We saw examples where the agency had worked well with other agencies to make sure people received care in a co-ordinated way.
Is the service well-led?
The service had a quality assurance system in place and records showed that identified problems and opportunities to change things for the better had been addressed promptly. The system included listening to people who used the service, their relatives and staff. The provider sought the views of people and consistently reviewed the service provided in response to the views expressed by them.
Staff told us they were clear about their roles and responsibilities. They told us that they could speak to a senior member of staff during office hours and the on-call manager after hours. A member of staff said, "The support is good. I phone or call at the office if I need advice. I have phoned the on-call manager after hours and have always had a swift and helpful response whenever I have needed help or advice."