1 September 2014
During a routine inspection
Is the service safe?
Safeguarding procedures were in place. Staff had undertaken safeguarding training and were clear about their responsibilities to report any incidents of potential abuse.
An effective recruitment and selection process and was in place for new staff. References and checks had been obtained to make sure that people were suitable for the work they were to perform. Staff had appropriate induction training to ensure they had the skills and competencies to care for people safely.
The provider had taken steps to improve medication support in people's homes. This included a monthly check of medication records to ensure medication was being administered correctly and safely. Staff were held responsible for any shortfalls.
Aspects of quality monitoring had been improved. Feedback from people who used the service had been sought from questionnaires and spot checks of staff whilst undertaking care to ensure they were providing care to required standards.
Reviews of care records including risk assessments had not taken place since the service commenced. This meant there was a risk of unsafe or inappropriate care and treatment arising from a lack of accurate information about people's current needs. We have asked the provider to tell us how they will make improvements.
Is the service effective?
Three people told us they were happy with the care and support they received and felt that their needs had been met. One person told us, "They give me the help I need. They (staff) are all excellent. I could not complain about anything." Another person compared the service with one they had previously used. The person told us, "This service is very reliable I cannot speak highly enough of them. They are on time, there are no missed calls and I can contact the manager at any time, including after hours."
Staff told us they had received good training and felt confident in meeting people's needs.
Is the service caring?
When speaking with staff it was clear that they had detailed knowledge of people's needs and how they wished to be supported. Staff genuinely cared for the people they supported.
The three people we spoke with who were being supported by the service told us they had no complaints. A person told us, "They always ask if there is anything more they can do to help me. Nothing is too much trouble for them. They will even do things to help that are probably not in the records".
Is the service responsive?
The service worked well with other agencies. We saw examples of the service responding well to unexpected hospital discharges.
We saw that care plans had not been reviewed. The registered manager worked regularly covering the rota to support people when staff had been unavailable. People we spoke with knew the manager well. It was clear that covering care calls was the priority.
Is the service well-led?
Quality monitoring of the service had improved since our last inspection with the introduction of questionnaires to seek feedback about the service and spot checks of staff whilst providing care to check if the service was delivering care to required standards.
Quality audits had been introduced to regularly check that medicines were being administered safely. Monthly evaluation of daily records completed by staff had been established to check the standards of care and support provided.
The manager worked alongside staff in the community, leading by example. This restricted the manager's time to take an overall view of the service and make any necessary changes.