28 June 2016
During a routine inspection
The inspection was conducted between 28 June and 1 July 2016 and was announced. We gave the provider 48 hours’ notice of our inspection as it was a domiciliary care service and we needed to be sure key staff members would be available.
There was not a registered manager in place. The manager was due to leave the service the week after inspection and the deputy manager was in the process of applying to CQC to be registered as the manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People received highly personalised care and support that met their individual needs. Care plans provided comprehensive information to enable staff to provide effective care and staff encouraged people to remain as independent as possible.
People and their families felt safe and trusted the staff who supported them. Staff understood their safeguarding responsibilities and knew how to prevent, identify and report abuse. Risks relating to the environment or the health and support needs of people were assessed and managed effectively. There was a business continuity plan in place to deal with foreseeable emergencies.
Medicines were given safely by staff who had been suitably trained. Staff recruitment practices were robust and helped ensure only suitable staff were employed. There were enough staff to support people. Staff were reliable, arrived on time and stayed for the agreed length of time.
Staff were knowledgeable and had received training to support the complex care needs of the person they supported. They felt confident and competent in the use of specialist equipment. They completed an effective induction programme and were appropriately supported in their work by supervisors, managers and a registered nurse.
People were encouraged to maintain a healthy, balanced diet based on their individual needs. Staff monitored people’s health and referred them to other healthcare professionals when needed. Staff were familiar with, and followed, legislation designed to protect people’s right.
Staff were sensitive to the fact that they were working in people’s homes and took care to be as discreet and unobtrusive as possible. People described them as “dedicated” and “kind”. Staff protected people’s privacy and involved them in decisions about their care.
The provider sought and acted on feedback from people. There was a suitable complaints policy in place and people knew how to complain. Complaints were welcomed and seen as an opportunity by senior staff to identify and make improvements.
People told us the service was well-led and said they would recommend it to others. There was a clear management structure and staff were required to work to a clear set of values.
There was a comprehensive quality assurance process in place which focused on continually improving the service provided. A wide range of audits was completed to assess and monitor the service, together with surveys of people and their relatives.