Background to this inspection
Updated
26 February 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector and an Expert 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
Inspection activity started on 17 January 2020 and ended on 31January 2020. We informed the provider that we had started the inspection on the 17 January 2020 and requested information relating to good governance. We informed them of when the site visit would take place. We visited the office location on 31 January 2020. The expert by experience contacted people and relatives by telephone
What we did before the inspection
The registered manager completed a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We also contacted Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
On 22 – 23 January 2020, the expert by experience telephoned 11 people and relatives. Two people and three relatives provided feedback about the service. We contacted another relative by email.
We spoke with the regional manager, the registered manager and one care worker. We contacted three care workers by email and received feedback from them about what it was like to work at the service. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We looked at two people’s care plans and recruitment checks for one staff member. We also reviewed training and supervision records, medicines administration records and records relating to the management of the service.
We emailed six health and social care professionals for their feedback.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found.
Updated
26 February 2020
About the service
The Grange provides personal care to people living in their own homes. At the time of our inspection, the service supported 30 people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People told us they felt safe with the staff who came into their homes. This was confirmed by relatives. One relative said, “They are literally our eyes and ears to keep my mum safe and happy and I can’t thank them enough.”
People and relatives told us that care and support was provided by a consistent team of staff. One person said, “Time keeping is never a problem. We always know who’s going to be coming, from the rota we get from the manager.”
Overall, medicines were managed safely. We identified several recording shortfalls which the registered manager told us would be addressed.
People were supported to eat and drink enough to maintain their health and wellbeing. Where required, staff assisted people to access healthcare services and receive ongoing healthcare support.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The registered manager was strengthening their documentation relating to mental capacity assessments and best interests’ decisions to ensure all areas of the process were evidenced.
People received personalised care which reflected their needs and preferences. One relative told us, “Her quality of life is much better with the support of the carers. She goes on trips to other villages and into Morpeth and they also take her to the dentist and opticians.”
A complaints procedure was in place. This did not accurately reflect CQC’s role in relation to complaints. The registered manager told us that this would be addressed. None of the people or relatives we spoke with raised any concerns or complaints.
Audits and spot checks were carried out to monitor the quality and safety of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 23 January 2019). We identified three breaches of the regulation. These related to staffing, need for consent and good governance. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.