17 January 2017
During a routine inspection
I & A Homecare Services Limited provide a personal care service to people in their own homes. The service provides a domiciliary care service throughout Accrington in Lancashire and surrounding areas. The agency office is staffed during the hours of 9:00 am to 5:00 pm, with a 24-hour on-call system for emergencies. At the time of our inspection there were 55 people receiving a service
We last visited I & A Homecare Services on the 26 November and 4 and 6 December 2015. During this inspection visit we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to a failure to ensure staff were trained and assessed as competent in safe administration of medication, failing to ensure staff received adequate training before they provided care and support and had regular supervision and a failure to effectively assess and monitor the quality of the service.
At the time of this inspection there was a manager in post who was currently applying to be registered as manager with the commission. 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.
During this inspection we found the service was meeting the current regulations.
There were appropriate arrangements in place to support people to take their medicines. People received their medicines as prescribed, by staff that had been trained to do this safely. People we spoke with told us their visits were arranged to ensure they got their medicines at the right time.
People using the service received care and support from a team of staff who had been recruited safely and trained to deliver safe and effective care and support. People we spoke with told us they felt safe from abuse or harm from the staff and they were treated with respect. They felt safe in their homes and they considered staff were trustworthy and respectful of their home.
People using the service and their relatives described the service as very good. They said staff were very respectful, attentive to their needs and treated them with kindness and respect when providing their support. Staff were also described in such terms as being caring and kind, very good and lovely people.
Safeguarding procedures were in place to guide and direct staff in reporting any concerns they had. Staff had been given basic training in safeguarding vulnerable people and knew what to do if they suspected any abusive or neglectful practice. Further training had been planned for. People we spoke with knew what to do if they had any concerns regarding the conduct of the staff who supported them.
Risks to people’s health, welfare and safety were managed very well. Risk assessments were completed and informed staff of the actions to take to support people safely. People knew they could contact the agency at any time and had emergency contact details for out of office hours. The service responded well to requests for urgent help.
Staff knew what to do in emergency situations and had guidance around keeping themselves and people they supported safe. Good arrangements were in place for staff to gain entry into people’s homes without placing them at risk. Staff were provided with protective equipment such as disposable gloves and aprons to minimise the risk of cross infection between people they visited.
Staff understood the principles of best interest decisions’ regarding people’s care and support and people’s diversity was embraced within their care plans. Arrangements were in place for staff to receive training in the principles of the Mental Capacity Act 2005. Care plans focused on the needs of people using the service. People’s right to privacy, dignity, choice and independence was acknowledged and respected.
Staff felt confident in their roles because they were trained and supported by the manager to gain further skills and qualifications relevant to their work. Staff were effectively supervised and were subject to spot checks to make sure high standards were being maintained at all times.
The service provided was flexible in meeting people’s needs. Visit times were scheduled to suit personal requirements and people we spoke with told us they could request a change of visit time and this was arranged. Assessment of people’s needs was an on-going process which meant any changes to their care was planned for. Changes to people’s needs and requirements were communicated well which meant staff were kept up to date with these changes.
People had opportunities to raise any issue of concern or pass on compliments about the service to the manager. People we spoke with had confidence in the manager to deal professionally with any complaint they raised.
People, their relatives and staff expressed their confidence in manager and felt the agency was very well managed. Staff performance was monitored well and staff were accountable for their practice. Tele monitoring was used to make sure staff were meeting their obligation in attending to people as and when required and ensure visits were never missed. Staff expressed job satisfaction and told us they felt valued.
We found there were good systems in place to assess and monitor the quality of the service, which included feedback from people using the service. Results of surveys completed showed a high satisfaction with the service people received.