Spinal Homecare Services Limited

At our last inspection in May 2016 we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post who is also one of the directors of the registered provider. 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.

There were sufficient numbers of suitable staff to meet people's needs. Induction training was comprehensive and training was on going. Staff were supported by the registered and care managers through regular staff meetings, supervision and appraisals.

When employing fit and proper persons the recruitment procedures had included all the required checks of suitability.

Hazards to people's safety had been identified and appropriately managed.

People's dignity and privacy were actively promoted by the staff supporting them.

People were given the opportunity to select their staff and who they were most compatible with. People received care from a team of staff who they knew well and treated them with respect.

Everyone we spoke with made very positive comments about the service provided and the staff who supported them.

Auditing and quality monitoring systems were in place that allowed the service to demonstrate it was safe and well managed.

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 told us this was an excellent service and said they would recommend it.

People received the support they needed to take their medicines safely. The staff identified if people were unwell and supported them to contact health professionals.

People were asked for their consent before care was provided and the decisions they made were respected.

Further information is in the detailed findings below

Spinal Homecare Services Limited provides two types of home care. One is specialised support provided on a live in basis for adults with spinal cord injury and other physical disabilities throughout the UK. The other is a domiciliary care and domestic support service mainly covering the rural areas of the Lune Valley.

During our previous inspection visit in February 2014 we found the service met all six of the essential standards we looked at. Since then there had been no incidents or concerns raised that have needed investigation.

There was a registered manager in post on the day of our inspection visit. 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. In this service the registered manager is also the registered provider.

We found that people who used this service were safe. The staff knew how to protect people from harm. Staff had completed training in the safety of vulnerable adults and knew the signs to look for and how to report any incidents of concern.

We saw that recruitment procedures were robust this ensured only suitable people worked in the service. We saw that staffing levels according to the rotas were good throughout all areas of the service. Staff training was up to date. We saw that staff were supported by the management team through regular staff supervision and appraisals.

We found that the service worked very well with a variety of external agencies such as social services, occupational therapists, other care providers and mental health professionals to provide appropriate care and support to meet people’s physical and emotional needs.

People received support mainly from a regular team of staff who they knew well and who understood the care and support they required. We saw that people were treated with kindness, dignity and respect and they made positive comments about the staff who visited their homes.

Support was given in a manner to people to promote their independence for example supporting them to join in with activities in the community.

The service followed the requirements of the Mental Capacity Act 2005 Code of practice. This helped to protect the rights of people who were not able to make important decisions themselves. Best interest meetings were held to assist people who were not always able to make difficult decisions for themselves and where relevant independent advocacy was arranged.

We found that some records relating to the management of peoples medications were not always accurate.

We recommended that the provider ensured the records relating to the administration of people’s medications were accurate and reflected their current needs.

We found that care planning was person centred, with individuals being involved in the development of their care and support. People were supported in a way that maximised their involvement and ensured that they had control over their lives.

Staff supervision and training was up to date and relevant to the roles and responsibilities of the people who worked at the agency. There were robust policies and procedures in place for the recruitment of staff. This ensured only suitable people were employed to provide support for people with a variety of needs.

We saw that the agency office provided the staff employed there with a safe environment in which to work. The premises had appropriate equipment in place for the detection and prevention of fire. Risk assessments had been completed to ensure the safety of people employed by the agency and any visitors to the offices.

The manager had implemented a quality monitoring system that ensured a high standard of care was provided to the people supported by this agency. We found accurate record keeping that evidenced people were protected from the risks of unsafe or inappropriate care and treatment.

We found that people's views and experiences were taken into account in the way the service was provided and they experienced care, treatment and support that met their needs and protected their rights. People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People were cared for, or supported by, suitably qualified, skilled and experienced staff and the provider had an effective system to regularly assess and monitor the quality of service that people received.