Home First - Stoke

Updated 6 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

This inspection was carried out by two inspectors 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 registered as a domiciliary care provider. It provides short term support with personal care and rehabilitation to people living in their own houses and flats. People can be referred to the service following discharge from hospital or to try and prevent a hospital admission.

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

We gave the service 72 hours’ notice of the inspection. This was because it is a large service and we were aware it would take time for the provider to notify people that the Expert by Experience may contact them for feedback . We also needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 10 December 2019 and ended on 11 December 2019. We visited the office location on 10 December 2019.

What we did before inspection

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 used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service and eight relatives about their experience of the care provided. We spoke with 15 members of staff including the service manager, registered manager, clinical lead, and support workers.

We reviewed a range of records. This included seven people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 6 February 2020

About the service

Home First -Stoke is registered as a domiciliary care service and commissioned to provide 1800 hours of support each week. At the time of inspection, they were supporting with 110 people, 52 of whom were receiving the regulated activity of 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.

Support was provided to people in their own homes on a short-term basis, usually between 2-6 weeks. The main office was based in a large building surrounded by other NHS and social care services.

People’s experience of using this service and what we found

People were supported by sufficient numbers of staff however the provider was not always able to provide a consistent staff team to undertake the care calls. Since the last inspection people were given more information about the service and how care calls would not always be set, but people still told us they would prefer greater predictability.

Due to the nature of the service, support was often restricted to the care tasks which had been agreed in advance.

People were treated with dignity and respect. An update to people's care assessment was needed, to ensure all of the protected characteristics were considered. People felt able to express their views.

People were protected from abuse by staff who had been trained in recognising and reporting abuse and issues of delayed reporting to the local authority had been resolved.

Risks to people’s safety were assessed and systems were in place to ensure key risks were clearly highlighted. People received their medicine from staff who had been trained in the safe administration of medicine. People were protected from the risk of infection by staff who had access to gloves which they wore during personal care.

There was a strong focus in the service on learning lessons when things went wrong and continuously trying to improve.

People’s needs were holistically assessed, and staff received training in how to support people with a range of different needs. The provider worked closely with other agencies to help people meet their desired outcomes.

People were supported to have their health needs met and people were supported with drinks and meals as required.

People were supported to have choice and control of their lives, as far at the service could facilitate. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Care was personalised to people’s assessed needs and information was made accessible when required. People’s care calls were managed to ensure they were able to maintain social activities.

Any complaints received were fully investigated and action taken when needed. People were supported with end of life care.

People told us the service was well managed, and staff told us they felt supported and kept up to date with what was happening in the service. The provider engaged with people and worked in partnership with others. The provider understood its duty of candour.

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 12 December 2018.)

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.