Background to this inspection
Updated
12 September 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.
The inspection took place on 31 July to 3 August 2018. We gave the service five days’ notice so that we could obtain information to help us with the inspection.
Before the inspection, we reviewed the action plan, information that we hold about the service such as safeguarding information and notifications. Notifications are the events happening in the service that the provider is required to tell us about. We also received feedback from the local authority. We used this information to plan what areas we were going to focus on during our inspection.
The inspection team consisted of two inspectors, an assistant inspector and two experts 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. Our two experts by experience had experience of using this type of service.
We visited the office location on 31 July 2018 to see the registered manager and office staff and on 1, 2, 3 August 2018 made telephone calls to people who used the service and relatives.
During our inspection, we spoke with the registered manager, the finance director, field care supervisor and two service managers, a human resources manager and eight care staff. We also spoke with 12 people who used the service and 12 relatives on the telephone.
We reviewed 11 people’s care files and eight staff recruitment and support records. We also looked at a sample of the service’s quality assurance, training, supervision, medicine administration and complaints records.
Updated
12 September 2018
This inspection took place on 31 July to 3 August 2018 and was announced giving five days’ notice so that we could obtain information to help us with the inspection.
At the last inspection on 15 to 21 December 2016, we found the provider was in breach of Regulation 9 (Person centred care), Regulation 12 (Safe care and treatment), Regulation 13. (Safeguarding service users), Regulation 17 (Good governance), and Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We rated the service as ‘Requires improvement’ in all areas with an overall rating of ‘Requires improvement’.
Following the inspection, we asked the provider to complete an action plan to show what they would do, and by when, to improve all the key questions to at least ‘Good’.
We found significant improvements had been made to the service when we returned on 31 July 2018, and the service was no longer in breach of the Regulations. We have judged their rating to be 'Good'.
Ideal Home Care Solutions provides a domiciliary care service. It is registered to provide the regulated activity of personal care and treatment of disease, disorder or injury to people in their own homes, including older people, people with dementia, people with a physical and sensory impairment and younger adults. At the time of the inspection, the service was caring for 145 people with 74 staff supporting them.
There was a registered manager in post. 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.
Systems were in place to ensure people felt safe. Missed and late calls had been significantly reduced through the implementation of technology which monitored staff movement of calls, rota arrangements and identified early action to take. The service had reviewed its staffing levels and arrangements and sufficient staff were in post to keep people safe. Additional management staff had also been employed to supervise the day to day delivery of care.
Care was provided in a safe way as the service now managed the risks to people’s health and wellbeing. Improvements had been made to people’s assessments of need and any risks associated with providing their care. These were carried out and provided detailed guidance to staff in caring for them safely. People told us that they were listened to, respected and communication with the management of the service had significantly improved.
The management of medicines had been improved and staff now recorded accurate information about how they administered people’s medicines. Systems were in place to ensure medicines were monitored and, staff competency to administer them, was checked and recorded.
The recording of information in people’s care plans had been improved to ensure staff understood and implemented the guidance and advice from professionals so that people received effective care. The recording of people’s needs and the review of their care was now accurate and consistent. The daily notes were person centred, respectful and clear.
Systems to monitor the quality of the service had significantly improved and were all in place to ensure the oversight of the service and the provision of high-quality care.
Staff knew how to protect people from the risk of harm. They had received training in how to recognise the signs of abuse and knew how to report any safeguarding concerns to their managers.
People were cared for by staff who had been safely recruited. Staff did not start work until all required employment checks had been carried out. Staff had the skills and knowledge to care and support people effectively.
Staff understood how to minimise the risk of infection, they had been trained, and had access to personal protective equipment such as gloves and aprons.
All the necessary training and supervision was in place for staff and they knew how to support people effectively. People were supported with a healthy diet and sufficient fluids. The service worked well in partnership with other professionals to ensure that people received the health care support they needed. Staff ensured people’s healthcare needs were met in a timely way.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were supported by friendly, kind and caring staff. Their independence was encouraged while minimising any risks to help keep them safe. People told us staff gave them the time they needed and what they expected and respected their dignity and privacy. Confidential information about people was stored safely in line with the new data protection requirements.
People and their relatives were very complimentary about the service. They told us they were kept involved in decision-making and had good contact with the management through visits and calls.
People received care that was responsive to their needs. Care plans had been improved as they were now written in a personalised, detailed and respectful way. People’s wishes to have a male or female staff member provide their care for example was recorded and now acted upon. More recorded information about people's diversity would ensure the service acknowledged their different needs.
There was a complaints procedure in place and people had confidence that any complaints would be dealt with quickly.
The service was well led and managed. There was a clear vision for the future of the service. Staff displayed sound values when talking about how they cared for people. Staff could tell us about the improvements to the service for people who used it and in their day to day work.
The registered manager learnt from audits and investigations and made the necessary improvements.
Further information is in the detailed findings below.