2, 19 May 2014
During a routine inspection
This is a summary of what we found;
Is the service safe?
People were safe because staffing levels were assessed and monitored to ensure they were sufficient to meet people's needs.
The premises used by the provider were suitable for running a small domiciliary service.
Where the service was responsible, people received their medicines as prescribed. However we found that the service was not always following safe practice in the recording of medicines. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.
People and their belongings were safe because the service assessed and managed risks associated with the environment. However we found improvements were required to ensure that staff were aware of any identified risks associated with a person's health care needs, and how they would be managed.
Is the service effective?
People told us that they felt that they were provided with a service that met their needs.
People were supported by the same core group of staff which promoted continuity of care. We saw examples where the service had effectively matched people with staff to make sure they were compatible. One person who gave us the names of their two regular care workers said they were, 'Both lovely, can have a laugh.'
We found the quality of the information given in people's care plans fluctuated. This was because some care plans provided detailed, step by step guidance for staff, to support person centred care. However, the contents of other people's care plans were incomplete or missing. Therefore it did provide staff with enough guidance to provide appropriate, personalised care. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.
Is the service caring?
People told us they were supported by kind, polite and caring staff. One person described the staff as, 'Fabulous.' Another person described staff as, 'Kind and marvellous.' Another described their regular care worker as, 'Lovely'we get on well together.'
Is the service responsive?
People's preferences and choices were taken in to account and listened to. However we found that improvements were needed. This was because discussions with two people identified that they were not asked to check the contents of their care plan when they had been written. We saw that if staff had taken the time to check the information with the person, they would have identified an error; and corrected it at that time.
People's care records showed that where concerns about their health and wellbeing had been identified that staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from health and social care professionals, including a doctor, dietician and social worker.
Is the service well-led?
People had met the registered manager in person when they had visited them to assess their needs. Therefore they could put a face to the name and felt comfortable to raise any concerns direct. One person described them as, 'Very friendly,' and had spent time with them, 'Asking lots of questions.'
People told us that the registered manager took on a, 'Hands on role,' covering shifts and accompanying staff during their first visit. The registered manager told us that they used the visits to gain feedback from people who used the service and check on the quality of service they received.
Where people had raised concerns, their concerns had been listened to and resolved. Where shortfalls had been identified, the provider had taken a 'lessons learnt' approach to improve their service.
A member of staff described the registered manager as supportive and could always be contacted.
One person asked us how long the service had been operating, as they felt it did not always come over as being very well organised. We found as the service had expanded during 2014, from one person using the service to 19. The effectiveness of the systems the service had in place to assess and monitor the quality of their service had not been able to keep up with the sudden growth. This meant that shortfalls in the completion and quality of risk assessments and care and medication records had not been picked up, and acted on. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.